| Cub Creek Therapy | |
|
6454 Joan Ln Evergreen CO 80439-7012 | |
| (508) 725-1872 | |
| Not Available |
| Full Name | Cub Creek Therapy |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6454 Joan Ln, Evergreen, Colorado |
| Authorized Official Name and Position | Lisa J Wainio (BCBA) |
| Authorized Official Contact | 5087251872 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cub Creek Therapy Po Box 984 Conifer CO 80433-0984 Ph: () - | Cub Creek Therapy 6454 Joan Ln Evergreen CO 80439-7012 Ph: (508) 725-1872 |
| NPI Number | 1063038644 |
|---|---|
| Provider Enumeration Date | 06/19/2020 |
| Last Update Date | 06/19/2020 |
| Certification Date | 06/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063038644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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