| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1325 W 50th St, Loveland, Colorado |
| Authorized Official Name and Position | Ronald L Telles (CFO) |
| Authorized Official Contact | 3606787656 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 24789 Seattle WA 98124-0789 Ph: (360) 678-7656 | 1325 W 50th St Loveland CO 80538 Ph: (360) 678-5151 |
| NPI Number | 1770022832 |
|---|---|
| Provider Enumeration Date | 02/21/2017 |
| Last Update Date | 06/01/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770022832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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