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General NPI Number Information
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NPI Number | 1902958358
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Entity Type | Organization
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Legal Business Name | GARY W. LEE
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 2150 CURTIS ST
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City | DENVER
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State | CO
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Zip | 80205-2519
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Country | US
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Telephone | 303-296-2244
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Fax | 303-296-1709
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Provider Business Mailing Address
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Address Line | 2150 CURTIS ST
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City | DENVER
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State | CO
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Zip | 80205-2519
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Country | US
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Telephone | 303-296-2244
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Fax | 303-296-1709
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Authorized Official
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Title or Position | OWNER
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Name | GARY W LEE
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Credential | LCSW
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Telephone | 303-296-2244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | LCSW-578
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License Number State | ID
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