| Northglenn | |
|
11698 Huron St Unit 106 Northglenn CO 80234 | |
| (720) 381-0264 | |
| Not Available |
| Full Name | Northglenn |
|---|---|
| Speciality | Behavior Analyst |
| Location | 11698 Huron St Unit 106, Northglenn, Colorado |
| Authorized Official Name and Position | Janice Fiorenza (SYSTEMS MANAGER) |
| Authorized Official Contact | 3039898174 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northglenn 390 Union Blvd Ste 300 Lakewood CO 80228-6514 Ph: (303) 989-8169 | Northglenn 11698 Huron St Unit 106 Northglenn CO 80234 Ph: (720) 381-0264 |
| NPI Number | 1396243739 |
|---|---|
| Provider Enumeration Date | 01/31/2018 |
| Last Update Date | 07/05/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396243739 | NPI | - | NPPES |
| 85850055 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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