Healthcare Provider Details

I. General information

NPI: 1225890254
Provider Name (Legal Business Name): SAGE ROSE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 04/11/2026
Certification Date: 04/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 E ARAPAHOE RD STE 106
CENTENNIAL CO
80112-1261
US

IV. Provider business mailing address

7600 E ARAPAHOE RD STE 106
CENTENNIAL CO
80112-1261
US

V. Phone/Fax

Practice location:
  • Phone: 720-613-5734
  • Fax: 720-405-4397
Mailing address:
  • Phone: 720-613-5734
  • Fax: 720-405-4397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGELA D PANEK
Title or Position: CEO
Credential: FNP-BC
Phone: 720-613-5734