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General NPI Number Information
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NPI Number | 1588176945
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Entity Type | Organization
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Legal Business Name | CONSORTIUM FOR OLDER ADULT WELLNESS
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Dates
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Enumeration Date | 10/25/2017
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Last Update Date | 10/25/2017
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Provider Practice Location Address
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Address Line | 3222 S VANCE ST STE 240
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City | LAKEWOOD
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State | CO
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Zip | 80227-5007
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Country | US
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Telephone | 303-984-1845
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Fax | 303-984-5962
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Provider Business Mailing Address
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Address Line | 3222 S VANCE ST STE 240
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City | LAKEWOOD
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State | CO
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Zip | 80227-5007
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Country | US
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Telephone | 303-984-1845
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Fax | 303-984-5962
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LYNNZY ORR MCINTOSH
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Credential |
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Telephone | 303-984-1845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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