| Legacy Mental Health Llc | |
|
13575 E 104th Ave Unit 300 Commerce City CO 80022-8401 | |
| (720) 689-1165 | |
| (616) 369-0917 |
| Full Name | Legacy Mental Health Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 13575 E 104th Ave Unit 300, Commerce City, Colorado |
| Authorized Official Name and Position | Typhanie Beasley (NURSE PRACTITIONER) |
| Authorized Official Contact | 7203386870 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Mental Health Llc 10940 S Parker Rd # 179 Parker CO 80134-7440 Ph: (720) 338-6870 | Legacy Mental Health Llc 13575 E 104th Ave Unit 300 Commerce City CO 80022-8401 Ph: (720) 689-1165 |
| NPI Number | 1104680271 |
|---|---|
| Provider Enumeration Date | 02/09/2024 |
| Last Update Date | 02/09/2024 |
| Certification Date | 02/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104680271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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