Basic Information
| Provider Information | |||||||||
| NPI: | 1336161371 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JEWISH FAMILY SERVICE OF COLORADO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3201 S TAMARAC DR | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802314394 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035975000 | ||||||||
| FaxNumber: | 3035977700 | ||||||||
| Practice Location | |||||||||
| Address1: | 3201 S TAMARAC DR | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802314394 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035975000 | ||||||||
| FaxNumber: | 3035977700 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2006 | ||||||||
| LastUpdateDate: | 07/14/2021 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | FOSTER | ||||||||
| AuthorizedOfficialFirstName: | LINDA | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT AND CEO | ||||||||
| AuthorizedOfficialTelephone: | 3035975000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 07/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251V00000X | Y | Agencies | Voluntary or Charitable |
ID Information
| ID | Type | State | Issuer | Description | 9147539 | 05 | CO | MEDICAID |