| Power-up Performance Llc | |
|
631 S Depew St Lakewood CO 80226-4845 | |
| (303) 547-0743 | |
| Not Available |
| Full Name | Power-up Performance Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 631 S Depew St, Lakewood, Colorado |
| Authorized Official Name and Position | Michael Hardin (LEAD CLINICIAN) |
| Authorized Official Contact | 3035470743 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Power-up Performance Llc 631 S Depew St Lakewood CO 80226-4845 Ph: (303) 547-0743 | Power-up Performance Llc 631 S Depew St Lakewood CO 80226-4845 Ph: (303) 547-0743 |
| NPI Number | 1871020594 |
|---|---|
| Provider Enumeration Date | 05/12/2017 |
| Last Update Date | 05/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871020594 | NPI | - | NPPES |
| 9000145803 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Colorado) | Primary |
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