Healthcare Provider Details

I. General information

NPI: 1477936672
Provider Name (Legal Business Name): MINDCARE SOLUTIONS OF COLORADO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 07/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 DUKE DR SUITE 210
FRANKLIN TN
37067-2706
US

IV. Provider business mailing address

405 DUKE DR SUITE 210
FRANKLIN TN
37067-2706
US

V. Phone/Fax

Practice location:
  • Phone: 844-291-4535
  • Fax: 615-653-4149
Mailing address:
  • Phone: 844-291-4535
  • Fax: 615-653-4149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOHN SHUSTER
Title or Position: COO
Credential: MD
Phone: 844-291-4535