06D2124927 CLIA NUMBER - VCPHCS XII, LLC DBA BHG CENTENNIAL TREATMENT CENTER

Laboratory Demographics

CLIA Number: 06D2124927

Facility Name: VCPHCS XII, LLC DBA BHG CENTENNIAL TREATMENT CENTER

Facility Address:
7286 SOUTH YOSEMITE ST, SUITE 125
CENTENNIAL, CO
ZIP 80112
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Facility Phone Number: 303 824-5866

Facility Type: Other - OPIOD TREATMENT CENTER

Certificate Type: Waiver

NPI Number: 1235673484

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	06D2124927
LAB Type	Other - OPIOD TREATMENT CENTER
Facility Name	VCPHCS XII, LLC DBA BHG CENTENNIAL TREATMENT CENTER
Street	7286 SOUTH YOSEMITE ST, SUITE 125
City	CENTENNIAL
State	CO
ZIP	80112
Phone	303 824-5866
CertificateType	4
CertificateEffectiveDate	1/27/2023
CertificateExpirationDate	1/26/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024