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General NPI Number Information
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NPI Number | 1114545126
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Entity Type | Organization
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Legal Business Name | HOPE MOUNTAIN, LLC
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Dates
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Enumeration Date | 07/07/2020
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Last Update Date | 07/07/2020
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Provider Practice Location Address
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Address Line | 6565 W JEWELL AVE # 4B1
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City | LAKEWOOD
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State | CO
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Zip | 80232-7187
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Country | US
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Telephone | 719-465-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 1802 CHAPEL HILLS DR STE A
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3736
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Country | US
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Telephone | 719-465-0900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY LEE MOWERY
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Credential | LPC
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Telephone | 719-465-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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