Basic Information
| Provider Information | |||||||||
| NPI: | 1407594260 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DENVER SPRINGS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4801 OLYMPIA PARK PLZ STE 1000 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402412090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5027929864 | ||||||||
| FaxNumber: | 5026148686 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 W HAMPDEN PL STE 200 | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801102534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7206440025 | ||||||||
| FaxNumber: | 3037815495 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2022 | ||||||||
| LastUpdateDate: | 05/23/2022 | ||||||||
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| AuthorizedOfficialLastName: | FASELLE | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8178816812 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | DENVER SPRINGS, LLC | ||||||||
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| NPICertificationDate: | 05/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | Y | Hospitals | Psychiatric Hospital |
No ID Information.