Colorado Coalition for the Homeless

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

CO DOES NOT REQUIRE Issued in CO

Legal business name

COLORADO COALITION FOR THE HOMELESS

Doing business as

Samaritan House Stout Street Clinic and Medical Respite

Practice address

2301 Lawrence St
Denver, CO 80205-2126

Phone

(303) 293-2217

Fax

(303) 293-2309

NPI assigned

Jan 8, 2015

Last updated

Aug 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pete J Stoller

Title

Cfo

Phone

(303) 312-9606

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Samaritan House Stout Street Clinic and Medical Respite Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528456878. Details of each certification follow.

• CCN 061966 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 061966

Legal name

SAMARITAN HOUSE STOUT STREET CLINIC AND RESPITE

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Apr 6, 2016

Last certification

Apr 6, 2016

Ownership / control type

For profit – corporation

Facility address

2301 Lawrence Street
Denver, CO 80205

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Colorado Coalition for the Homeless

  dba CCH- Administration/Clinical & Support Services

  • Federally Qualified Health Center (FQHC)
  • Denver, CO
  • NPI 1538557889

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1528456878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 CHAMPA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052529",
            "telephone_number": "303-293-2217",
            "fax_number": "303-293-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 LAWRENCE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052126",
            "telephone_number": "303-293-2217",
            "fax_number": "303-293-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO COALITION FOR THE HOMELESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "STOLLER",
        "authorized_official_first_name": "PETE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "303-312-9606"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CO",
            "license": "CO DOES NOT REQUIRE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32055374",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "061966",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samaritan House Stout Street Clinic and Medical Respite",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Samaritan House Stout Street Clinic and Medical Respite",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Colorado Coalition for the Homeless (West End Health Center)
• Colorado Coalition for the Homeless (Quigg Newton)
• Colorado Coalition for the Homeless (Renaissance Downtown Lofts)
• Colorado Coalition for the Homeless
• Colorado Coalition for the Homeless (Renaissance at Stout Street Lofts)
• Colorado Coalition for the Homeless (CCH- Administration/Clinical & Support Services)
• Colorado Coalition for the Homeless (48th Avenue)
• Colorado Coalition for the Homeless (Forum Apartments)
• Colorado Coalition for the Homeless
• Colorado Coalition for the Homeless (Renaissance Off Broadway Lofts)

• Federally Qualified Health Center (FQHC) in Denver, CO
• Providers in Denver, CO by specialty
• Federally Qualified Health Center (FQHC) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.