Provider Demographics
NPI:1215932884
Name:FOREST HEIGHTS LODGE INC.
Entity type:Organization
Organization Name:FOREST HEIGHTS LODGE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:HENNINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-600-3702
Mailing Address - Street 1:13922 DENVER WEST PARKWAY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401
Mailing Address - Country:US
Mailing Address - Phone:303-674-6681
Mailing Address - Fax:303-674-6805
Practice Address - Street 1:13922 DENVER WEST PARKWAY
Practice Address - Street 2:SUITE 150
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401
Practice Address - Country:US
Practice Address - Phone:303-674-6681
Practice Address - Fax:303-674-6805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty