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NPI Code Detail

MEDICARE: INN BETWEEN

MEDICARE: INN BETWEEN
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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center150413CO
2310400000XAssisted Living Facility

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174765366
Entity Type Code : Organization
Provider Name (Legal Business Name) : INN BETWEEN
Provider Business Mailing Address
First Line : 4851 INDEPENDENCE ST STE 200
Second Line :
City : WHEAT RIDGE
State : CO
Zip : 80033-6712
Country : US
Telephone Number : 303-425-0300
Fax Number : 303-432-5071
Provider Business Practice Location Address
First Line : 10295 W KEENE AVE
Second Line :
City : LAKEWOOD
State : CO
Zip : 80235-1104
Country : US
Telephone Number : 303-980-4082
Fax Number : 303-980-4084
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : DAVID A GOFF
Credential :
Telephone Number : 303-432-5164
Provider Enumeration Date : 04/02/2009
Last Update Date : 12/18/2020

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Directions to “INN BETWEEN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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