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NPI Code Detail

MEDICARE: MENTAL HEALTH CENTER OF DENVER

MEDICARE: MENTAL HEALTH CENTER OF DENVER
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
1333600000XPharmacy576CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10619203OTHERNCPDP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952394207
Entity Type Code : Organization
Provider Name (Legal Business Name) : MENTAL HEALTH CENTER OF DENVER
Provider Business Mailing Address
First Line : 4141 E DICKENSON PL
Second Line :
City : DENVER
State : CO
Zip : 80222-6012
Country : US
Telephone Number : 303-504-7799
Fax Number : 303-512-8860
Provider Business Practice Location Address
First Line : 4455 E 12TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80220-2415
Country : US
Telephone Number : 303-504-7799
Fax Number : 303-512-8860
Authorized Official
Title or Position : PRESIDENT AND CEO
Name : ROBERT CARL CLARK
Credential : MD
Telephone Number : 303-504-6500
Provider Enumeration Date : 08/23/2005
Last Update Date : 01/24/2023

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Directions to “MENTAL HEALTH CENTER OF DENVER ” Practice Location

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