| Inner Life Adventures, Llc | |
|
343 W Drake Rd Ste 200 Fort Collins CO 80526-2880 | |
| (970) 829-0478 | |
| Not Available |
| Full Name | Inner Life Adventures, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 343 W Drake Rd Ste 200, Fort Collins, Colorado |
| Authorized Official Name and Position | Charles S Hancock (LPC, OWNER) |
| Authorized Official Contact | 9705564095 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Life Adventures, Llc 343 W Drake Rd Ste 200 Fort Collins CO 80526-2880 Ph: (970) 829-0478 | Inner Life Adventures, Llc 343 W Drake Rd Ste 200 Fort Collins CO 80526-2880 Ph: (970) 829-0478 |
| NPI Number | 1689255390 |
|---|---|
| Provider Enumeration Date | 04/15/2021 |
| Last Update Date | 04/15/2021 |
| Certification Date | 04/15/2021 |
| Medicare PECOS PAC ID | 6305286857 |
|---|---|
| Medicare Enrollment ID | O20240501000029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689255390 | NPI | - | NPPES |
| Provider Name | Charles S Hancock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780954776 PECOS PAC ID: 7113367665 Enrollment ID: I20240501000040 |
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