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NPI Code Detail

MEDICARE: INTEGRATED PSYCHIATRIC SERVICES LLC

MEDICARE: INTEGRATED PSYCHIATRIC SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WG0000XGeneral Practice Registered Nurse
2363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1417592114
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTEGRATED PSYCHIATRIC SERVICES LLC
Provider Business Mailing Address
First Line : 627 24 1/2 RD STE F
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81505-1277
Country : US
Telephone Number : 970-644-5013
Fax Number : 970-658-1138
Provider Business Practice Location Address
First Line : 627 24 1/2 RD STE F
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81505-1277
Country : US
Telephone Number : 970-644-5013
Fax Number : 970-658-1138
Authorized Official
Title or Position : CO-OWNER
Name : MELINDA BETH ALLEN
Credential : DNP
Telephone Number : 970-644-5013
Provider Enumeration Date : 11/17/2019
Last Update Date : 08/11/2022

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Directions to “INTEGRATED PSYCHIATRIC SERVICES LLC ” Practice Location

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