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NPI Code Detail

MEDICARE: BOULDER SHELTER FOR THE HOMELESS, INC. DBA ALL ROADS

MEDICARE: BOULDER SHELTER FOR THE HOMELESS, INC. DBA ALL ROADS
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1265270557
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOULDER SHELTER FOR THE HOMELESS, INC. DBA ALL ROADS
Provider Business Mailing Address
First Line : 4869 BROADWAY ST
Second Line :
City : BOULDER
State : CO
Zip : 80304-0523
Country : US
Telephone Number : 303-442-4646
Fax Number :
Provider Business Practice Location Address
First Line : 4869 BROADWAY ST
Second Line :
City : BOULDER
State : CO
Zip : 80304-0523
Country : US
Telephone Number : 303-442-4646
Fax Number :
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MICHAEL BLOCK
Credential :
Telephone Number : 303-247-0678
Provider Enumeration Date : 07/19/2024
Last Update Date : 07/19/2024

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Directions to “BOULDER SHELTER FOR THE HOMELESS, INC. DBA ALL ROADS ” Practice Location

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