Healthcare Provider Details
I. General information
NPI: 1699329649
Provider Name (Legal Business Name): ARAHANT MENTAL WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/29/2019
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7525 W 10TH AVE SUITE 200
LAKEWOOD CO
80214
US
IV. Provider business mailing address
7525 W 10TH AVE SUITE 200
LAKEWOOD CO
80214
US
V. Phone/Fax
- Phone: 720-209-8537
- Fax: 303-756-1920
- Phone: 720-209-8537
- Fax: 303-756-1920
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0802X |
| Taxonomy | Addiction Psychiatry Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HY GIA
PARK
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 808-286-1607