Provider Demographics
NPI:1255360301
Name:INTERMOUNTAIN FRONT RANGE, INC.
Entity type:Organization
Organization Name:INTERMOUNTAIN FRONT RANGE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-425-2410
Mailing Address - Street 1:3210 LUTHERAN PKWY
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6019
Mailing Address - Country:US
Mailing Address - Phone:303-425-8000
Mailing Address - Fax:303-403-7295
Practice Address - Street 1:3210 LUTHERAN PKWY
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6019
Practice Address - Country:US
Practice Address - Phone:303-425-8000
Practice Address - Fax:303-403-7295
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTEGRITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO315D00000X315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05800107Medicaid
CO05800107Medicaid