| Warm Ground Open Sky, Llc | |
|
5123 Williams Fork Trl Apt 102 Boulder CO 80301-3446 | |
| (720) 364-6333 | |
| Not Available |
| Full Name | Warm Ground Open Sky, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5123 Williams Fork Trl Apt 102, Boulder, Colorado |
| Authorized Official Name and Position | Stefan James Bigboy (CO-OWNER) |
| Authorized Official Contact | 7203646333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Warm Ground Open Sky, Llc 5123 Williams Fork Trl Apt 102 Boulder CO 80301-3446 Ph: (720) 364-6333 | Warm Ground Open Sky, Llc 5123 Williams Fork Trl Apt 102 Boulder CO 80301-3446 Ph: (720) 364-6333 |
| NPI Number | 1609583459 |
|---|---|
| Provider Enumeration Date | 11/01/2022 |
| Last Update Date | 11/01/2022 |
| Certification Date | 11/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609583459 | NPI | - | NPPES |
| 9000206037 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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