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General NPI Number Information
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NPI Number | 1043045842
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Entity Type | Organization
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Legal Business Name | ELIZABETH WELLS, LLC
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Dates
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Enumeration Date | 09/03/2024
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 6105 S MAIN ST STE 200
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City | AURORA
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State | CO
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Zip | 80016-5361
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Country | US
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Telephone | 847-903-0584
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Fax |
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Provider Business Mailing Address
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Address Line | 19762 E PIKES PEAK AVE APT 204
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City | PARKER
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State | CO
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Zip | 80138-7476
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Country | US
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Telephone | 847-903-0584
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH WELLS
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Credential |
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Telephone | 847-903-0584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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