| Heart Space Llc | |
|
309 S Cascade Ave Montrose CO 81401-4201 | |
| (970) 765-7734 | |
| Not Available |
| Full Name | Heart Space Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 309 S Cascade Ave, Montrose, Colorado |
| Authorized Official Name and Position | Cristi Anne Wilson (OWNER) |
| Authorized Official Contact | 9707657734 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heart Space Llc 309 S Cascade Ave Montrose CO 81401-4201 Ph: (970) 765-7734 | Heart Space Llc 309 S Cascade Ave Montrose CO 81401-4201 Ph: (970) 765-7734 |
| NPI Number | 1013493980 |
|---|---|
| Provider Enumeration Date | 07/13/2018 |
| Last Update Date | 07/03/2023 |
| Certification Date | 07/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013493980 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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