Healthcare Provider Details

I. General information

NPI: 1366384794
Provider Name (Legal Business Name): ROOTED ALCHEMY COLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4145 XAVIER ST
DENVER CO
80212-2231
US

IV. Provider business mailing address

4145 XAVIER ST
DENVER CO
80212-2231
US

V. Phone/Fax

Practice location:
  • Phone: 616-560-8458
  • Fax:
Mailing address:
  • Phone: 616-560-8458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: SARA MOSER
Title or Position: CO-FOUNDER
Credential:
Phone: 616-560-8458