Healthcare Provider Details

I. General information

NPI: 1881325058
Provider Name (Legal Business Name): ALDER GROVE HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2022
Last Update Date: 06/20/2022
Certification Date: 06/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 S CLOVER DR STE 5
BAYFIELD CO
81122-8833
US

IV. Provider business mailing address

90 MADISON ST STE 302
DENVER CO
80206-5412
US

V. Phone/Fax

Practice location:
  • Phone: 720-331-6899
  • Fax: 720-306-5499
Mailing address:
  • Phone: 720-331-6899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HOLLY VAUSE
Title or Position: OWNER
Credential:
Phone: 720-331-6899