| Growth Odyssey Llc | |
|
3595 E Fountain Blvd Ste 240 Colorado Springs CO 80910-7715 | |
| (719) 415-3510 | |
| (719) 938-1914 |
| Full Name | Growth Odyssey Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3595 E Fountain Blvd Ste 240, Colorado Springs, Colorado |
| Authorized Official Name and Position | Larry Jay Alwine (OWNER) |
| Authorized Official Contact | 7194153510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Growth Odyssey Llc 3595 E Fountain Blvd Ste 240 Colorado Springs CO 80910-7715 Ph: (719) 415-3510 | Growth Odyssey Llc 3595 E Fountain Blvd Ste 240 Colorado Springs CO 80910-7715 Ph: (719) 415-3510 |
| NPI Number | 1649987744 |
|---|---|
| Provider Enumeration Date | 10/31/2022 |
| Last Update Date | 05/10/2023 |
| Certification Date | 05/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649987744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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