| Idea-thornton | |
|
9051 Washington St Thornton CO 80229-4335 | |
| (303) 996-9966 | |
| Not Available |
| Full Name | Idea-thornton |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9051 Washington St, Thornton, Colorado |
| Authorized Official Name and Position | Miguel Avina (COO) |
| Authorized Official Contact | 3034778280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idea-thornton 9051 Washington St Thornton CO 80229-4335 Ph: (303) 996-9966 | Idea-thornton 9051 Washington St Thornton CO 80229-4335 Ph: (303) 996-9966 |
| NPI Number | 1114221678 |
|---|---|
| Provider Enumeration Date | 12/27/2010 |
| Last Update Date | 05/14/2024 |
| Certification Date | 05/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114221678 | NPI | - | NPPES |
| 9000149330 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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