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General NPI Number Information
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NPI Number | 1881017366
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Entity Type | Organization
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Legal Business Name | HEALING WARRIORS PROGRAM
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 2001 S SHIELDS ST BUILDING L
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City | FORT COLLINS
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State | CO
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Zip | 80526-1827
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Country | US
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Telephone | 970-776-8787
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Fax |
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Provider Business Mailing Address
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Address Line | 6525 GUNPARK DR SUITE 370-195
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City | BOULDER
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State | CO
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Zip | 80301-3346
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Country | US
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Telephone | 970-776-8387
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ANA YELEN
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Credential | MSM, CHTP, HTCP
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Telephone | 720-231-9484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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