Provider Demographics
NPI:1447038591
Name:JACOB HOUSE MENTAL HEALTH SERVICES
Entity type:Organization
Organization Name:JACOB HOUSE MENTAL HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HOPE
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD PSYCHOLOGY
Authorized Official - Phone:303-525-6141
Mailing Address - Street 1:2700 YOUNGFIELD ST STE 206
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-7079
Mailing Address - Country:US
Mailing Address - Phone:303-525-6141
Mailing Address - Fax:303-986-5005
Practice Address - Street 1:2700 YOUNGFIELD ST STE 206
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-7079
Practice Address - Country:US
Practice Address - Phone:303-525-6141
Practice Address - Fax:303-986-5005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-19
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty