MEDICARE: COLORADO HEALTH NETWORK, INC

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	251S00000X	Community/Behavioral Health Agency	1697-01	CO

General Provider Information

NPI Number	:	1194008623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLORADO HEALTH NETWORK, INC

Provider Business Mailing Address
First Line	:	6260 E COLFAX AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-1515
Country	:	US
Telephone Number	:	303-962-5317
Fax Number	:	303-832-7823

Provider Business Practice Location Address
First Line	:	6260 E COLFAX AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-1515
Country	:	US
Telephone Number	:	303-962-5317
Fax Number	:	303-832-7823

Authorized Official
Title or Position	:	CHIEF CLINICAL OFFICER
Name	:	LILI CARRILLO
Credential	:	MHL
Telephone Number	:	303-962-5317

Provider Enumeration Date	:	09/21/2011
Last Update Date	:	03/15/2023

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