NPIMap

Organization Active NPI

Idea-Brighton

  • Community/Behavioral Health Agency
  • Brighton, CO
National Provider Identifier
1396049854
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
IDEA-BRIGHTON
Practice address
1295 E Bridge St Ste 104
Brighton, CO 80601-2278
Phone
(303) 659-9440
Fax
(303) 659-9430
NPI assigned
Dec 27, 2010
Last updated
May 14, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
IDEA FORUM INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Authorized official

Name
Miguel Avina
Title
Coo
Phone
(303) 477-8280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

1295 E Bridge St Ste 104
Brighton, CO 80601-2278

Mailing address

1295 E Bridge St Ste 104
Brighton, CO 80601-2278
Phone (303) 659-9440

Other identifiers 1

IdentifierTypeStateIssuer
9000149328MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Idea-Brighton4 organizations share this tax ID, including this one
Part of
Idea-Brighton

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1295 E Bridge St
Ste 104
Brighton, CO 80601
Phone (303) 659-9440

2420 E Bridge St
Unit B
Brighton, CO 80601

2560 W 29th Ave
Denver, CO 80211
Phone (303) 477-8280

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1396049854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 E BRIDGE ST STE 104",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806012278",
            "telephone_number": "303-659-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 E BRIDGE ST STE 104",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806012278",
            "telephone_number": "303-659-9440",
            "fax_number": "303-659-9430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEA-BRIGHTON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IDEA FORUM INC.",
        "enumeration_date": "2010-12-27",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "AVINA",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "303-477-8280"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000149328",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.