Healthcare Provider Details

I. General information

NPI: 1982919809
Provider Name (Legal Business Name): BIENESTAR GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2010
Last Update Date: 08/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 CHAMBERS RD SUITE 256
DENVER CO
80239-5152
US

IV. Provider business mailing address

4860 CHAMBERS RD SUITE 256
DENVER CO
80239-5152
US

V. Phone/Fax

Practice location:
  • Phone: 719-246-8449
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number19738
License Number StateCO

VIII. Authorized Official

Name: JAMES WINKLER
Title or Position: CEO
Credential:
Phone: 719-246-8449