| Sage Space Retreat Llc | |
|
8536 Foxhaven Dr. Longmont CO 80503-8698 | |
| (720) 963-8111 | |
| Not Available |
| Full Name | Sage Space Retreat Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 8536 Foxhaven Dr., Longmont, Colorado |
| Authorized Official Name and Position | Elena Georgouses (CO-OWNER/CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 9704712297 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sage Space Retreat Llc 8536 Foxhaven Dr. Longmont CO 80503-8698 Ph: (970) 471-2297 | Sage Space Retreat Llc 8536 Foxhaven Dr. Longmont CO 80503-8698 Ph: (720) 963-8111 |
| NPI Number | 1043077092 |
|---|---|
| Provider Enumeration Date | 03/05/2024 |
| Last Update Date | 03/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043077092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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