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General NPI Number Information
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NPI Number | 1750532206
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Entity Type | Organization
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Legal Business Name | DENVER HEALTH AUTHORITY
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 10/02/2008
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Provider Practice Location Address
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Address Line | 777 BANNOCK ST UNIT 9 777 BANNOCK ST. UNIT-9
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City | DENVER
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State | CO
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Zip | 80204-4507
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Country | US
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Telephone | 303-436-5686
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Fax | 303-463-5071
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Provider Business Mailing Address
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Address Line | 777 BANNOCK ST UNIT 9 777 BANNOCK ST. UNIT-9
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City | DENVER
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State | CO
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Zip | 80204-4507
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Country | US
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Telephone | 303-436-5686
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Fax | 303-463-5071
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Authorized Official
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Title or Position | ADDICITON COUNSELOR LEVEL II
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Name | MS. HOPE CONNIE PRUITT
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Credential | CAC II
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Telephone | 303-436-5685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 276400000X
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Taxonomy Name | Substance Use Disorder Rehabilitation Hospital Unit
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License Number | 6575
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License Number State | CO
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