| Stride Chc - Jefferson Plaza Family Health At Jefferson Center | |
|
3595 South Teller Street Lakewood CO 80235-2014 | |
| (303) 239-9964 | |
| (303) 237-4343 |
| Full Name | Stride Chc - Jefferson Plaza Family Health At Jefferson Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3595 South Teller Street, Lakewood, Colorado |
| Authorized Official Name and Position | Ben R. Wiederholt (PRESIDENT AND CEO) |
| Authorized Official Contact | 3037611977 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stride Chc - Jefferson Plaza Family Health At Jefferson Center 2255 S Oneida St Denver CO 80224-2522 Ph: (303) 761-1977 | Stride Chc - Jefferson Plaza Family Health At Jefferson Center 3595 South Teller Street Lakewood CO 80235-2014 Ph: (303) 239-9964 |
| NPI Number | 1679931646 |
|---|---|
| Provider Enumeration Date | 02/05/2016 |
| Last Update Date | 03/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679931646 | NPI | - | NPPES |
| 60135131 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Colorado) | Primary |
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