| Divine Health Group Llc | |
|
1206 E 3rd St La Junta CO 81050-1907 | |
| (719) 413-5261 | |
| Not Available |
| Full Name | Divine Health Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1206 E 3rd St, La Junta, Colorado |
| Authorized Official Name and Position | Cheyenne Elaine Kuhn (OWNER) |
| Authorized Official Contact | 7194135261 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Health Group Llc 1206 E 3rd St La Junta CO 81050-1907 Ph: (719) 413-5261 | Divine Health Group Llc 1206 E 3rd St La Junta CO 81050-1907 Ph: (719) 413-5261 |
| NPI Number | 1164120796 |
|---|---|
| Provider Enumeration Date | 02/22/2023 |
| Last Update Date | 03/29/2023 |
| Certification Date | 03/29/2023 |
| Medicare PECOS PAC ID | 6002271947 |
|---|---|
| Medicare Enrollment ID | O20230428002197 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164120796 | NPI | - | NPPES |
| 1285128413 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Cheyenne E Kuhn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285128413 PECOS PAC ID: 3476921727 Enrollment ID: I20221118000613 |
Southeast Mental Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 613 Barnes Ave, La Junta, CO 81050 Phone: 719-384-5446 Fax: 719-384-5672 | |
Ark Valley Counseling & Supervision Services, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 24600 County Road 21, La Junta, CO 81050 Phone: 719-469-2670 | |
Ark Valley Counseling & Supervision Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 317 W 3rd St Ste 203, La Junta, CO 81050 Phone: 719-469-2670 | |
Valley Community Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 313 W 3rd Street Lincoln Square Professional Building, Suite 204, La Junta, CO 81050 Phone: 719-469-0799 | |
Single Point Services Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 302 Barnes Ave, La Junta, CO 81050 Phone: 719-384-8503 Fax: 719-384-8411 | |
Valley-wide Health System, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 721 Barnes Ave, La Junta, CO 81050 Phone: 719-384-5446 |