Organization Name: | STOUT STREET FOUNDATION |
NPI Number: | 1104248947 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NICHOLAS JOEL PETRUCELLI (VICE PRESIDENT OF PROGRAMS) |
Mailing Address: | 7201 E 49th Ave Commerce City |
State: | CO US |
Postal Code: | 800224714 |
Phone Number: | 3033212533 |
Fax Number: | 3034686184 |
NPI Enumeration Date: | 01/14/2014 |
NPI Last Update Date: | 01/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 324500000X |
License Number: | 139909 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Substance Abuse Rehabilitation Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |