| |
800 Englewood Pkwy Suite B202 Englewood CO 80110-7315 | |
(303) 777-0303 | |
(303) 733-4565 |
Full Name | |
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Speciality | Community/Behavioral Health |
Location | 800 Englewood Pkwy, Englewood, Colorado |
Authorized Official Name and Position | Louis Leon Bruno (EXECUTIVE MEDICAL DIRECTOR) |
Authorized Official Contact | 3037770303 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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16350 E Arapahoe Rd # 108-323 Foxfield CO 80016-1557 Ph: (303) 777-0303 | 800 Englewood Pkwy Suite B202 Englewood CO 80110-7315 Ph: (303) 777-0303 |
NPI Number | 1306086418 |
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Provider Enumeration Date | 03/02/2009 |
Last Update Date | 12/17/2024 |
Certification Date | 12/17/2024 |
Medicare PECOS PAC ID | 5890932123 |
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Medicare Enrollment ID | O20130506000257 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306086418 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Louis Bruno |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1770637159 PECOS PAC ID: 9234376443 Enrollment ID: I20130508000130 |
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