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General NPI Number Information
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NPI Number | 1760843478
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Entity Type | Organization
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Legal Business Name | ON SOLID GROUND LLC
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Dates
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Enumeration Date | 03/09/2016
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Last Update Date | 03/09/2016
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Provider Practice Location Address
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Address Line | 210 E SIMPSON ST
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City | LAFAYETTE
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State | CO
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Zip | 80026-2324
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Country | US
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Telephone | 720-988-8874
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Fax |
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Provider Business Mailing Address
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Address Line | 210 E SIMPSON ST
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City | LAFAYETTE
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State | CO
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Zip | 80026-2324
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Country | US
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Telephone | 720-988-8874
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Fax |
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Authorized Official
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Title or Position | OWNER / COUNSELOR
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Name | STEVEN MOORE
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Credential | M.A.
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Telephone | 720-988-8874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | NLC.0104380
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License Number State | CO
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