Healthcare Provider Details

I. General information

NPI: 1073970760
Provider Name (Legal Business Name): MINDFUL LIVING POSSIBILITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7355 S PEORIA ST UNIT A12
ENGLEWOOD CO
80112-4532
US

IV. Provider business mailing address

7355 S PEORIA ST UNIT A12
ENGLEWOOD CO
80112-4532
US

V. Phone/Fax

Practice location:
  • Phone: 720-882-6224
  • Fax:
Mailing address:
  • Phone: 720-882-6224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUSAN ZUMWALT
Title or Position: COACH/PRESIDENT
Credential:
Phone: 720-882-6224