NPI | 1316233174 |
---|---|
Doing Business As | STRIDE CHC - INDEPENDENCE AT JEFFERSON CENTER |
Other Name | INDEPENDENCE HEALTH CENTER AT JEFFERSON CENTER FOR MENTAL HEALTH |
Entity Type | Organization |
Authorized Contact | BEN R. WIEDERHOLT President And CEO 303-761-1977 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2011-06-21 |
Last Update Date | 2020-03-10 |