| Diversus Health Inc | |
| 
					100 West Bennett Ave Cripple Creek CO 80813  | |
| (719) 572-6100 | |
| Not Available | 
| Full Name | Diversus Health Inc | 
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) | 
| Location | 100 West Bennett Ave, Cripple Creek, Colorado | 
| Authorized Official Name and Position | Gene Contreras (VP, ACCOUNTING & FINANCE) | 
| Authorized Official Contact | 7195726197 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Diversus Health Inc 220 Ruskin Dr Colorado Springs CO 80910-2522 Ph: () -  | Diversus Health Inc 100 West Bennett Ave Cripple Creek CO 80813 Ph: (719) 572-6100  | 
| NPI Number | 1144685918 | 
|---|---|
| Provider Enumeration Date | 12/22/2015 | 
| Last Update Date | 01/09/2024 | 
| Certification Date | 01/09/2024 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1144685918 | NPI | - | NPPES | 
| 29735033 | Medicaid | CO | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary | 
Bloom Wellness Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 W Bennett Avenue, Cripple Creek, CO 80813 Phone: 719-286-9077  | |
Pickett Psychological Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 W. Bennett Avenue, Cripple Creek, CO 80813 Phone: 719-598-3585  |