| Sample Services | |
|
606 Mountain View Ave Longmont CO 80501-2779 | |
| (303) 523-8057 | |
| Not Available |
| Full Name | Sample Services |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 606 Mountain View Ave, Longmont, Colorado |
| Authorized Official Name and Position | Carmen Louise Sample (CEO) |
| Authorized Official Contact | 7206846309 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sample Services 606 Mountain View Ave Longmont CO 80501-2779 Ph: (303) 523-8057 | Sample Services 606 Mountain View Ave Longmont CO 80501-2779 Ph: (303) 523-8057 |
| NPI Number | 1568791911 |
|---|---|
| Provider Enumeration Date | 12/14/2009 |
| Last Update Date | 01/31/2023 |
| Certification Date | 01/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568791911 | NPI | - | NPPES |
| 1568791911 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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