| Imagine | |
|
1400 Dixon Ave Lafayette CO 80026 | |
| (303) 665-7789 | |
| Not Available |
| Full Name | Imagine |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1400 Dixon Ave, Lafayette, Colorado |
| Authorized Official Name and Position | Robin Grey (CFO) |
| Authorized Official Contact | 3036416342 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imagine 1400 Dixon Ave Lafayette CO 80026-2790 Ph: (303) 665-7789 | Imagine 1400 Dixon Ave Lafayette CO 80026 Ph: (303) 665-7789 |
| NPI Number | 1679147193 |
|---|---|
| Provider Enumeration Date | 05/19/2021 |
| Last Update Date | 11/01/2024 |
| Certification Date | 11/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679147193 | NPI | - | NPPES |
| 42800145 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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