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General NPI Number Information
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NPI Number | 1548388325
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Entity Type | Organization
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Legal Business Name | JEFFERSON HILLS CORPORATION
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 12/22/2014
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Provider Practice Location Address
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Address Line | 421 ZANG ST
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City | LAKEWOOD
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State | CO
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Zip | 80228-1052
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Country | US
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Telephone | 303-989-4357
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Fax | 303-988-2017
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Provider Business Mailing Address
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Address Line | 421 ZANG ST
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City | LAKEWOOD
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State | CO
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Zip | 80228-1052
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Country | US
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Telephone | 303-989-4357
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Fax | 303-988-2017
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Authorized Official
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Title or Position | CONTROLLER
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Name | CHRISTINE ELLIS
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Credential |
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Telephone | 303-969-3822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 88459
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License Number State | CO
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