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General NPI Number Information
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NPI Number | 1871181586
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Entity Type | Organization
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Legal Business Name | IN THE SHELTER LLC
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Dates
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Enumeration Date | 01/07/2021
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 7505 VILLAGE SQUARE DR STE 207
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City | CASTLE PINES
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State | CO
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Zip | 80108-3693
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Country | US
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Telephone | 303-903-1124
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Fax |
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Provider Business Mailing Address
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Address Line | 8919 BERMUDA RUN CIR
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80130-3309
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Country | US
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Telephone | 303-335-5709
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DALE CARL FREDRICKSON
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Credential | MA, MDIV, PHD (ABD)
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Telephone | 303-323-4722
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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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