Organization · Type 2 NPI

Metro Community Provider Network, Inc.

Federally Qualified Health Center (FQHC) · Lakewood, CO

NPI number 1861014805 Active

Practice location

3595 S Teller St Fl 4
Lakewood, CO 80235-2014

Call (303) 360-6276 Map

Fax (303) 274-7093

Mailing address

2255 S Oneida St
Denver, CO 80224-2522

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

Another provider at this address

Metro Community Provider Network, Inc.Federally Qualified Health Center (FQHC) Lakewood, CO NPI 1447873773

Other federally qualified health center (fqhc) providers in Lakewood

See all in Lakewood →

NPI record

NPI: 1861014805
Entity type: Organization (Type 2)
Issued: May 13, 2020
Last updated: May 13, 2020
Status: Active
Subpart: Yes of Metro Community Provider Network, Inc.

Other names

Stride CHC - Jefferson Plaza Behavioral Health at Jefferson Center · doing business as

Authorized official

Ben Wiederholt
President & CEO
(303) 761-1977

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1861014805

Metro Community Provider Network, Inc.'s National Provider Identifier is 1861014805, issued on May 13, 2020. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Lakewood, CO. The record was last updated on May 13, 2020.