Healthcare Provider Details

I. General information

NPI: 1881887594
Provider Name (Legal Business Name): AUBERGINE CENTER FOR HEALING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2007
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 E 1ST AVE SUITE 360
DENVER CO
80206-5810
US

IV. Provider business mailing address

3300 E 1ST AVE SUITE 360
DENVER CO
80206-5810
US

V. Phone/Fax

Practice location:
  • Phone: 303-322-9164
  • Fax:
Mailing address:
  • Phone: 303-322-9164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1025
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4824
License Number StateCO

VIII. Authorized Official

Name: DR. JASMINE SKYLER ALLEXI
Title or Position: OPERATIONS MANAGER
Credential: D.C., L.AC.
Phone: 303-322-9164