Healthcare Provider Details

I. General information

NPI: 1356944201
Provider Name (Legal Business Name): ABUNDANCE CENTER FOR CHANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2020
Last Update Date: 08/20/2021
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14201 E 4TH AVE STE 260
AURORA CO
80011-8000
US

IV. Provider business mailing address

14201 E 4TH AVE STE 260
AURORA CO
80011-8000
US

V. Phone/Fax

Practice location:
  • Phone: 720-779-7766
  • Fax:
Mailing address:
  • Phone: 720-779-7766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KRISTIN LUNDQUIST
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 720-297-0202