Healthcare Provider Details

I. General information

NPI: 1497244495
Provider Name (Legal Business Name): HEALINGQUEST LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2018
Last Update Date: 05/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 WALNUT ST
BOULDER CO
80302-5032
US

IV. Provider business mailing address

3434 47TH ST STE 130
BOULDER CO
80301-1802
US

V. Phone/Fax

Practice location:
  • Phone: 303-225-2708
  • Fax: 303-225-2708
Mailing address:
  • Phone: 303-532-6780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1134524275
Identifier TypeOTHER
Identifier State
Identifier IssuerNPI

VIII. Authorized Official

Name: ANDREW NEWKIRK ROSE
Title or Position: DIRECTOR
Credential:
Phone: 303-225-2708