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General NPI Number Information
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NPI Number | 1437893906
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Entity Type | Organization
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Legal Business Name | OWL AND EAGLE ENTERPRISES, LLC
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Dates
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Enumeration Date | 04/21/2022
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 7350 E PROGRESS PL STE 100
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2130
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Country | US
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Telephone | 303-736-9697
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Fax | 720-306-5464
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Provider Business Mailing Address
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Address Line | 430 INDIANA ST STE 100
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City | GOLDEN
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State | CO
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Zip | 80401-5012
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Country | US
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Telephone | 303-736-9697
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Fax | 720-306-5464
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Authorized Official
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Title or Position | CFO
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Name | MITCHELL FRALLER
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Credential |
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Telephone | 303-736-9697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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