| Executive Center MH | |
|
70 Executive Center Ii 4851 Independence Street Suite 270 Wheatridge CO 80033 | |
| (303) 467-5850 | |
| Not Available |
| Full Name | Executive Center MH |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 70 Executive Center Ii, Wheatridge, Colorado |
| Authorized Official Name and Position | Cortney a Eisses (REGIONAL PRESIDENT) |
| Authorized Official Contact | 3039578351 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Center MH 10350 E Dakota Ave Denver CO 80247-1314 | Executive Center MH 70 Executive Center Ii 4851 Independence Street Suite 270 Wheatridge CO 80033 Ph: (303) 467-5850 |
| NPI Number | 1003920786 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 09/18/2026 |
| Certification Date | 09/18/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003920786 | NPI | - | NPPES |
| 04710083 | Medicaid | CO | |
| 30478251 | Medicaid | CO | |
| 04510301 | Medicaid | CO | |
| 04020087 | Medicaid | CO |
Robert P Domaleski MD PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4045 Wadsworth, #100, Wheatridge, CO 80033 Phone: 303-421-3331 Fax: 303-421-1309 |