| Outdoor Counseling Collective Llc | |
|
2855 Bergen Peak Dr Evergreen CO 80439-2204 | |
| (708) 805-9292 | |
| Not Available |
| Full Name | Outdoor Counseling Collective Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2855 Bergen Peak Dr, Evergreen, Colorado |
| Authorized Official Name and Position | Patrick Michael Minaghan (OWNER) |
| Authorized Official Contact | 7088059292 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Outdoor Counseling Collective Llc 1945 La Quinta Ln Evergreen CO 80439-8958 Ph: (708) 805-9292 | Outdoor Counseling Collective Llc 2855 Bergen Peak Dr Evergreen CO 80439-2204 Ph: (708) 805-9292 |
| NPI Number | 1225745177 |
|---|---|
| Provider Enumeration Date | 10/31/2022 |
| Last Update Date | 10/31/2022 |
| Certification Date | 10/31/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225745177 | NPI | - | NPPES |
| 1770986408 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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