Organization · NPI-2

Back To Life Counseling, LLC

Community/Behavioral Health · Longmont, CO

NPI number1134581580
StatusActive
Last updated in NPPESMar 24, 2016

Details

NPI
1134581580
Entity type
Organization (NPI-2)
Legal business name
Back To Life Counseling, LLC
Organization subpart
No
Enumeration date
Mar 24, 2016
Last updated
Mar 24, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health1751-01COYes

Practice location

500 9th Ave Ste 10
Longmont, CO 80501-4599

Phone 303-651-2554 · Fax 303-485-2477

Mailing address

500 9th Ave Ste 10
Longmont, CO 80501-4599

Phone 303-651-2554 · Fax 303-485-2477

Authorized official

David Allen Packard
Owner Director
3036512554

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