| NPI | 1396793030 |
|---|---|
| Doing Business As | STOUT STREET CLINIC |
| Entity Type | Organization |
| Authorized Contact | PETE J STOLLER CFO 303-312-9606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CO 1042) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-07-09 |