| |
3595 South Teller Street Lakewood CO 80235-2014 | |
(303) 239-9964 | |
(303) 237-4343 |
Full Name | |
---|---|
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 |
---|---|
2255 S Oneida St Denver CO 80224-2522 Ph: (303) 761-1977 | 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 |
Comprehensive Behavioral Health Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5300 W Alameda Ave, Lakewood, CO 80226 Phone: 303-885-4774 | |
Lakewood Injury Treatment Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 605 Parfet St, Suite 104, Lakewood, CO 80215 Phone: 303-330-0024 Fax: 303-232-1798 |