Provider Demographics
NPI:1174099857
Name:I HAVE A DREAM FOUNDATION - COLORADO
Entity type:Organization
Organization Name:I HAVE A DREAM FOUNDATION - COLORADO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR OF CLINICAL SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:AIMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCORN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-861-5005
Mailing Address - Street 1:1836 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203
Mailing Address - Country:US
Mailing Address - Phone:303-861-5005
Mailing Address - Fax:303-861-5008
Practice Address - Street 1:4800 TELLURIDE ST BLDG 5
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-6803
Practice Address - Country:US
Practice Address - Phone:303-861-5005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-19
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty