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1793 Kendall St Lakewood CO 80214-1454 | |
(303) 293-2220 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1793 Kendall St, Lakewood, Colorado |
Authorized Official Name and Position | Pete J Stoller (CFO) |
Authorized Official Contact | 3033129606 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2111 Champa St Denver CO 80205-2529 Ph: (303) 293-2220 | 1793 Kendall St Lakewood CO 80214-1454 Ph: (303) 293-2220 |
NPI Number | 1073279618 |
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Provider Enumeration Date | 11/09/2021 |
Last Update Date | 01/02/2025 |
Identifier | Type | State | Issuer |
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1073279618 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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