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General NPI Number Information
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NPI Number | 1841518404
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Entity Type | Organization
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Legal Business Name | IDEA FORUM INC.
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Dates
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Enumeration Date | 05/06/2010
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Last Update Date | 05/14/2024
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Provider Practice Location Address
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Address Line | 2370 W ALAMEDA AVE
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City | DENVER
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State | CO
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Zip | 80223-1991
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Country | US
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Telephone | 303-477-8280
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Fax | 303-477-1369
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Provider Business Mailing Address
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Address Line | 2370 W ALAMEDA AVE UNIT 8
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City | DENVER
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State | CO
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Zip | 80223-1991
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Country | US
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Telephone | 303-477-8280
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Fax | 303-477-1369
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Authorized Official
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Title or Position | COO
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Name | MIGUEL AVINA
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Credential |
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Telephone | 303-477-8280
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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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