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NPI Code Detail

MEDICARE: STOUT STREET FOUNDATION

MEDICARE: STOUT STREET FOUNDATION
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
1324500000XSubstance Abuse Rehabilitation Facility139909CO

General Provider Information

NPI Number : 1841377876
Entity Type Code : Organization
Provider Name (Legal Business Name) : STOUT STREET FOUNDATION
Provider Business Mailing Address
First Line : 7251 E 49TH AVE
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-4714
Country : US
Telephone Number : 303-321-2533
Fax Number : 303-468-6199
Provider Business Practice Location Address
First Line : 7251 E 49TH AVE
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-4714
Country : US
Telephone Number : 303-321-2533
Fax Number : 303-468-6199
Authorized Official
Title or Position : SUPERVISOR
Name : KATIE BRYDON
Credential : LCSW, LAC
Telephone Number : 720-401-2340
Provider Enumeration Date : 11/01/2006
Last Update Date : 10/16/2025

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Directions to “STOUT STREET FOUNDATION ” 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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