Rocky Mountain Psychiatric Associates, Llc | |
75 Manhattan Dr Ste 204 Boulder CO 80303-4252 | |
(303) 569-8858 | |
(303) 647-9214 |
Full Name | Rocky Mountain Psychiatric Associates, Llc |
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Speciality | Psychiatry & Neurology |
Location | 75 Manhattan Dr Ste 204, Boulder, Colorado |
Authorized Official Name and Position | Gwendolyn Gregory Grace (PSYCHIATRIST) |
Authorized Official Contact | 3035698858 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Rocky Mountain Psychiatric Associates, Llc 75 Manhattan Dr Ste 204 Boulder CO 80303-4252 Ph: (303) 569-8858 | Rocky Mountain Psychiatric Associates, Llc 75 Manhattan Dr Ste 204 Boulder CO 80303-4252 Ph: (303) 569-8858 |
NPI Number | 1023726825 |
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Provider Enumeration Date | 11/10/2022 |
Last Update Date | 11/10/2022 |
Certification Date | 11/10/2022 |
Medicare PECOS PAC ID | 7416327788 |
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Medicare Enrollment ID | O20221230002108 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023726825 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Emily E Bucy |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1467552117 PECOS PAC ID: 9537138706 Enrollment ID: I20080208000424 |
Provider Name | Gwendolyn G Grace |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1194925594 PECOS PAC ID: 4880871763 Enrollment ID: I20110601000419 |
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