Provider Demographics
NPI:1548635980
Name:DAVID E. ROSE
Entity type:Organization
Organization Name:DAVID E. ROSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERPAIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:303-659-3639
Mailing Address - Street 1:457 POPPY DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-3345
Mailing Address - Country:US
Mailing Address - Phone:303-659-3639
Mailing Address - Fax:
Practice Address - Street 1:457 POPPY DR
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-3345
Practice Address - Country:US
Practice Address - Phone:303-659-3639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO119652015251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health