| Green Space Cooperative Ltd | |
|
1942 Broadway Ste 314c Boulder CO 80302-5233 | |
| (719) 286-0059 | |
| Not Available |
| Full Name | Green Space Cooperative Ltd |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1942 Broadway Ste 314c, Boulder, Colorado |
| Authorized Official Name and Position | Jade Phinn (CEO) |
| Authorized Official Contact | 7192860058 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Space Cooperative Ltd 1424 N Pearl St Apt 305 Denver CO 80203-2027 Ph: () - | Green Space Cooperative Ltd 1942 Broadway Ste 314c Boulder CO 80302-5233 Ph: (719) 286-0059 |
| NPI Number | 1790557148 |
|---|---|
| Provider Enumeration Date | 10/27/2023 |
| Last Update Date | 10/27/2023 |
| Certification Date | 10/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790557148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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