Mama Bird Wellness, LLC
Community/Behavioral Health in Lafayette, CO. Organization (NPI-2).
NPI number1154776946
StatusActive
Last updated in NPPESApr 28, 2016
Details
- NPI
- 1154776946
- Entity type
- Organization (NPI-2)
- Legal business name
- Mama Bird Wellness, LLC
- Organization subpart
- No
- Enumeration date
- Apr 28, 2016
- Last updated
- Apr 28, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | CSW.00002154 | CO | Yes |
Practice location
424 E Simpson StLafayette, CO 80026-2328
Phone 303-835-3552
Mailing address
2013 E 167th WayThornton, CO 80602-7650
Phone 303-835-3552
Authorized official
Jessica Hanlin
Owner
3038353552
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