| Grand Valley Wellness, Llc | |
|
300 Stafford Ln Ste 30248 Delta CO 81416-2247 | |
| (970) 399-5990 | |
| Not Available |
| Full Name | Grand Valley Wellness, Llc |
|---|---|
| Speciality | Counselor |
| Location | 300 Stafford Ln Ste 30248, Delta, Colorado |
| Authorized Official Name and Position | Laura Anne Blair (OWNER) |
| Authorized Official Contact | 9704140707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Valley Wellness, Llc 300 Stafford Ln Ste 30248 Delta CO 81416-2247 Ph: (970) 399-5990 | Grand Valley Wellness, Llc 300 Stafford Ln Ste 30248 Delta CO 81416-2247 Ph: (970) 399-5990 |
| NPI Number | 1225760671 |
|---|---|
| Provider Enumeration Date | 06/24/2022 |
| Last Update Date | 02/27/2024 |
| Certification Date | 02/27/2024 |
| Medicare PECOS PAC ID | 4587003223 |
|---|---|
| Medicare Enrollment ID | O20240415002458 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225760671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Laura Anne Blair |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184995532 PECOS PAC ID: 8224440383 Enrollment ID: I20240415003137 |
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