MEDICARE: I HAVE A DREAM FOUNDATION-COLORADO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1043035892
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	I HAVE A DREAM FOUNDATION-COLORADO

Provider Business Mailing Address
First Line	:	1836 N GRANT ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-1123
Country	:	US
Telephone Number	:	303-861-5005
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 W NEVADA PL
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-2740
Country	:	US
Telephone Number	:	303-861-5005
Fax Number	:

Authorized Official
Title or Position	:	SR. DIRECTOR OF EMOTIONAL WELLNESS
Name	:	AIMEE ALCORN
Credential	:	LCSW
Telephone Number	:	303-861-5005

Provider Enumeration Date	:	11/18/2024
Last Update Date	:	11/18/2024

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