NPIMap

Organization Active NPI

Community Alcohol/Drug Rehabilitation Center

  • Physiological Laboratory
  • Denver, CO
National Provider Identifier
1730183161
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
License
1142-00 Issued in CO
Legal business name
COMMUNITY ALCOHOL/DRUG REHABILITATION CENTER
Practice address
3315 Gilpin St
Denver, CO 80205-4015
Phone
(303) 295-2521
Fax
(303) 295-2326
NPI assigned
Jun 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Authorized official

Name
Dr. Jacques Ama Okonji, PH.D.
Title
Executive Director
Phone
(303) 295-2521

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X 1142-00 CO Primary

Addresses

Primary practice location

3315 Gilpin St
Denver, CO 80205-4015

Mailing address

3315 Gilpin St
Denver, CO 80205-4015
Phone (303) 295-2521

Other identifiers 1

IdentifierTypeStateIssuer
1143OtherCOLICENSED OUT-PATIENT

Other names 1

  • CADREC Doing business as

National Provider Directory

National Provider Directory

Locations

3315 N Gilpin St
Denver, CO 80205
Phone (303) 295-2521

Practitioners & affiliated clinicians

Practitioners 1

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": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1730183161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 GILPIN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802054015",
            "telephone_number": "303-295-2521",
            "fax_number": "303-295-2326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 GILPIN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802054015",
            "telephone_number": "303-295-2521",
            "fax_number": "303-295-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ALCOHOL/DRUG REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "OKONJI",
        "authorized_official_first_name": "JACQUES",
        "authorized_official_middle_name": "AMA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "303-295-2521",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "CO",
            "license": "1142-00",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED OUT-PATIENT",
            "identifier": "1143",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CADREC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.