Organization Name: | YOUR HEALING PLACE |
NPI Number: | 1003041914 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK CARNEY (PRESIDENT) |
Mailing Address: | 7120 E Hampden Ave Suite B Denver |
State: | CO US |
Postal Code: | 802243048 |
Phone Number: | 3036360000 |
Fax Number: | |
NPI Enumeration Date: | 05/20/2009 |
NPI Last Update Date: | 05/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | 891 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |