Healthcare Provider Details
I. General information
NPI: 1023793668
Provider Name (Legal Business Name): ALL IS WELL FAMILY PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/20/2023
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7076 S ALTON WAY STE G1
CENTENNIAL CO
80112-2027
US
IV. Provider business mailing address
PO BOX 4602
GREENWOOD VILLAGE CO
80155-4602
US
V. Phone/Fax
- Phone: 720-800-3565
- Fax: 720-405-4192
- Phone: 720-800-3565
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MARTIN
JOSEPH
RIOS
Title or Position: AGENT
Credential:
Phone: 720-800-3565