NPIMap

Organization Active NPI

Jefferson Center for Mental Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Black Hawk, CO
National Provider Identifier
1497414650
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
JEFFERSON CENTER FOR MENTAL HEALTH
Practice address
15193 Highway 119
Black Hawk, CO 80422-4072
Phone
(303) 425-0300
Fax
(303) 432-5071
NPI assigned
Dec 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

15193 Highway 119
Black Hawk, CO 80422-4072

Mailing address

4851 Independence St
Wheat Ridge, CO 80033-6715
Phone (303) 425-0300

National Provider Directory

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

Organizations with this tax ID in the same state 24

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

View all 24

Locations

11030 Kitty Dr
Conifer, CO 80433
Phone (303) 838-7552

3595 S Teller St
Ste 200
Lakewood, CO 80235
Phone (720) 713-0587

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639440000000",
    "number": "1497414650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4851 INDEPENDENCE ST",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336715",
            "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": "15193 HIGHWAY 119",
            "city": "BLACK HAWK",
            "state": "CO",
            "postal_code": "804224072",
            "telephone_number": "303-425-0300",
            "fax_number": "303-432-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON CENTER FOR MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-14",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A",
        "authorized_official_last_name": "GOFF",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "303-432-5164",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Black Hawk, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.