NPIMap

Organization Active NPI

Jefferson Center for Mental Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Wheat Ridge, CO
National Provider Identifier
1902048192
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
150413 Issued in CO
Legal business name
JEFFERSON CENTER FOR MENTAL HEALTH
Practice address
4643 Wadsworth Blvd
Wheat Ridge, CO 80033-3305
Phone
(303) 463-7400
Fax
(303) 412-3368
NPI assigned
Apr 2, 2009
Last updated
Dec 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 150413 CO Primary

Addresses

Primary practice location

4643 Wadsworth Blvd
Wheat Ridge, CO 80033-3305

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
9000157909MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Jefferson Center for Mental57 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

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

View all 17

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": "1607040000000",
    "number": "1902048192",
    "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": "4643 WADSWORTH BLVD",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800333305",
            "telephone_number": "303-463-7400",
            "fax_number": "303-412-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON CENTER FOR MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-02",
        "last_updated": "2020-12-04",
        "certification_date": "2020-10-29",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "CO",
            "license": "150413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000157909",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.