| Samaritan House Stout Street Clinic And Medical Respite | |
|
2301 Lawrence St Denver CO 80205-2126 | |
| (303) 293-2217 | |
| (303) 293-2309 |
| Full Name | Samaritan House Stout Street Clinic And Medical Respite |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2301 Lawrence St, Denver, 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 |
|---|---|
| Samaritan House Stout Street Clinic And Medical Respite 2111 Champa St Denver CO 80205-2529 Ph: (303) 293-2217 | Samaritan House Stout Street Clinic And Medical Respite 2301 Lawrence St Denver CO 80205-2126 Ph: (303) 293-2217 |
| NPI Number | 1528456878 |
|---|---|
| Provider Enumeration Date | 01/08/2015 |
| Last Update Date | 08/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528456878 | NPI | - | NPPES |
| 32055374 | Medicaid | CO | |
| 061966 | Other | CO | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | CO DOES NOT REQUIRE (Colorado) | Primary |
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