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General NPI Number Information
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NPI Number | 1659166858
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Entity Type | Organization
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Legal Business Name | LIFE-LINE COLORADO
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Dates
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Enumeration Date | 04/10/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 1240 W BAYAUD AVE
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City | DENVER
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State | CO
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Zip | 80223-1213
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Country | US
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Telephone | 720-275-1739
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Fax |
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Provider Business Mailing Address
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Address Line | 1240 W BAYAUD AVE
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City | DENVER
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State | CO
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Zip | 80223-1213
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Country | US
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Telephone | 720-275-1739
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Fax |
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Authorized Official
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Title or Position | FOUNDER/EXECUTIVE DIRECTOR
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Name | LEO ALIREZ
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Credential | P.H. D., C.A.S.
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Telephone | 720-275-1739
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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