PATHFINDERS RECOVERY CENTER COLORADO, LLC (NPI# 1558889493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558889493 |
| Entity Type | Organization |
| Organization Name | PATHFINDERS RECOVERY CENTER COLORADO, LLC |
| Practice Address |
12157 W Cedar Dr Ste 100 Lakewood CO 80228-2102 |
| Practice Telephone | 9732775359 |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2017-08-30 |
| Authorized Official Name | MR. BRYAN MATTHEW DISIMONE (ACCOUNT MANAGER) |
| Authorized Official Telephone | 9732775359 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
1845-00 | CO | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Pathfinders Recovery Center Colorado, LLC | 7600 E Redfield Rd, Building A, Suite 105, Scottsdale, AZ 85260 |
| Street Address |
12157 W CEDAR DR STE 100 |
| City | LAKEWOOD |
| State | CO |
| Zip Code | 80228-2102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013541937 | Julia Margaret Wilson | Counselor | 12157 W Cedar Dr Ste 100, Lakewood, CO 80228-2102 | 2020-02-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174083570 | Lindsey Mae Beverly | Physician Assistant | Medical Plaza 2, 11700 W 2nd Pl, #350, Lakewood, CO 80228 | 2019-03-21 |
| 1881119931 | Cory J Frazier | Nurse Practitioner | 11600 W. 2nd Pl, Lakewood, CO 80228 | 2017-08-10 |
| 1508213885 | Chelsea Tucker | Counselor | 12157 W Cedar Dr Ste 207, Lakewood, CO 80228 | 2016-05-17 |
| 1972963841 | Shastin Gerbracht | Counselor | 12055 W 2nd Pl, Ste 200, Lakewood, CO 80228 | 2016-03-04 |
| 1073983375 | Suzanne Phillips | Behavioral Analyst | 200 Union Blvd. Ste. 200, Lakewood, Co. 80228, Denver, CO 80228 | 2015-09-29 |
| 1700265667 | April Mearsha | Doula | 12977 W Cedar Dr, 2-305, Lakewood, CO 80228 | 2015-05-26 |
| 1306233713 | Caleb Hedberg | Internal Medicine | 165 S Union Blvd Ste 800, Lakewood, CO 80228 | 2015-04-23 |
| 1972996288 | David Lindsey Currie | Counselor | 12055 W 2nd Place, Jefferson Ctr for Mental Health, Lakewood, CO 80228 | 2015-03-11 |
| 1619365533 | Michelle Broberg II | Technician | 12055 West 2nd Plaza, Lakewood, CO 80228 | 2014-12-30 |
| 1750789012 | Kayla Morrison | Social Worker | 12005 W 2nd Place, Lakewood, CO 80228 | 2014-12-18 |
| Find all providers in zip 80228 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1265674451 | Jefferson Center for Mental Health | Clinic/Center | 9485 W Colfax Ave, Lakewood, CO 80215-3918 | 2009-04-02 |
| 1306097654 | Jefferson Center for Mental Health | Clinic/Center | 9808 W Cedar Ave, Lakewood, CO 80226-1023 | 2008-10-06 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.