Healthcare Provider Details

I. General information

NPI: 1922089333
Provider Name (Legal Business Name): HEALTHONE CLINIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1719 E 19TH AVE
DENVER CO
80218-1235
US

IV. Provider business mailing address

720 S COLORADO BLVD SUITE 220A
GLENDALE CO
80246-1912
US

V. Phone/Fax

Practice location:
  • Phone: 303-869-2484
  • Fax: 303-839-6369
Mailing address:
  • Phone: 303-584-8000
  • Fax: 303-584-8000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM KING
Title or Position: CEO
Credential:
Phone: 303-584-8000