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General NPI Number Information
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NPI Number | 1770167470
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Entity Type | Organization
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Legal Business Name | HARVEST THERAPEUTIC SERVICES LLC
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Dates
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Enumeration Date | 05/09/2021
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 1780 S BELLAIRE ST STE 801
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City | DENVER
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State | CO
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Zip | 80222-4328
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Country | US
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Telephone | 720-653-9149
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Fax | 720-541-6641
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Provider Business Mailing Address
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Address Line | 1780 S BELLAIRE ST STE 801
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City | DENVER
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State | CO
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Zip | 80222-4328
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Country | US
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Telephone | 206-539-1497
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Fax | 720-541-6641
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Authorized Official
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Title or Position | OWNER
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Name | DR. KELLI HENDERSON
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Credential | DMFT
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Telephone | 303-921-2771
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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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