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General NPI Number Information
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NPI Number | 1801490859
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Entity Type | Organization
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Legal Business Name | MILE HIGH PSYCHIATRY LLC
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 4545 POST OAK PLACE DR STE 110
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City | HOUSTON
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State | TX
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Zip | 77027-3105
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Country | US
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Telephone | 720-507-4779
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Fax | 720-367-5067
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Provider Business Mailing Address
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Address Line | 15355 E COLFAX AVE UNIT 111717
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City | AURORA
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State | CO
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Zip | 80042-1975
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Country | US
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Telephone | 720-507-4779
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Fax | 720-367-5067
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL K CHISM
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Credential |
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Telephone | 720-507-4779
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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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