NPIMap

Organization Active NPI

Inn Between

  • Assisted Living Facility
  • Lakewood, CO
National Provider Identifier
1174765366
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
INN BETWEEN
Practice address
10295 W Keene Ave
Lakewood, CO 80235-1104
Phone
(303) 980-4082
Fax
(303) 980-4084
NPI assigned
Apr 2, 2009
Organization subpart
Yes
Parent organization
JEFFERSON CENTER FOR MENTAL HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David A Goff
Title
Chief Financial Officer
Phone
(303) 432-5164

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 150413 CO
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

10295 W Keene Ave
Lakewood, CO 80235-1104

Mailing address

4851 Independence St Ste 200
Wheat Ridge, CO 80033-6712
Phone (303) 425-0300

Other identifiers 2

IdentifierTypeStateIssuer
45175233MedicaidCO
9000175762MedicaidCO

Other names 1

  • Jefferson Center for Mental Health Other name

National Provider Directory

National Provider Directory
Tax ID family
Jefferson Ctr Mental Health57 organizations share this tax ID, including this one
Part of
Jefferson Ctr Mental Health

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1174765366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4851 INDEPENDENCE ST STE 200",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336712",
            "telephone_number": "303-425-0300",
            "fax_number": "303-432-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10295 W KEENE AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802351104",
            "telephone_number": "303-980-4082",
            "fax_number": "303-980-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INN BETWEEN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JEFFERSON CENTER FOR MENTAL HEALTH",
        "enumeration_date": "2009-04-02",
        "last_updated": "2020-12-18",
        "certification_date": "2020-11-10",
        "status": "A",
        "authorized_official_last_name": "GOFF",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "303-432-5164"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CO",
            "license": "150413",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45175233",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000175762",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Center for Mental Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.