| Alder Grove Wellness Group, Llc | |
|
90 Madison St Suite 400 Denver CO 80206-5418 | |
| (720) 331-6899 | |
| (720) 889-9496 |
| Full Name | Alder Grove Wellness Group, Llc |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 90 Madison St, Denver, Colorado |
| Authorized Official Name and Position | Holly Vause (PSYCHIATRIC NURSE PRACTITIONER) |
| Authorized Official Contact | 7203316899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alder Grove Wellness Group, Llc 90 Madison St Suite 400 Denver CO 80206-5418 Ph: (720) 331-6899 | Alder Grove Wellness Group, Llc 90 Madison St Suite 400 Denver CO 80206-5418 Ph: (720) 331-6899 |
| NPI Number | 1497171771 |
|---|---|
| Provider Enumeration Date | 03/11/2014 |
| Last Update Date | 03/11/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497171771 | NPI | - | NPPES |
| 58008314 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 00001020 (Colorado) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 164461 (Colorado) | Primary |
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