Healthcare Provider Details

I. General information

NPI: 1306783345
Provider Name (Legal Business Name): MOTHER SAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 1/2 N MAIN ST
GUNNISON CO
81230-2404
US

IV. Provider business mailing address

1401 ROCK CREEK RD
GUNNISON CO
81230-2289
US

V. Phone/Fax

Practice location:
  • Phone: 720-217-3843
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LOUISE PERRY
Title or Position: OWNER
Credential:
Phone: 720-217-3843