Organization Name: | MENTAL HEALTH CENTER BOULDER COUNTY |
NPI Number: | 1477754521 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BENJAMIN CUNNINGHAM (YOUTH ADVOCATE) |
Mailing Address: | 1333 Iris Ave Boulder |
State: | CO US |
Postal Code: | 803042226 |
Phone Number: | 3036840555 |
Fax Number: | |
NPI Enumeration Date: | 05/29/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |