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General NPI Number Information
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NPI Number | 1912418344
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Entity Type | Organization
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Legal Business Name | TEN PEAKS CHURCH
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Dates
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Enumeration Date | 10/12/2017
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Last Update Date | 10/12/2017
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Provider Practice Location Address
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Address Line | 409 MAIN STREET SUITE 220B
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City | FRISCO
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State | CO
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Zip | 80443
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Country | US
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Telephone | 970-389-3560
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5173
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City | FRISCO
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State | CO
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Zip | 80443-5173
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Country | US
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Telephone |
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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 | MRS. APRIL BENNETT
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Credential |
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Telephone | 970-389-3560
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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 | 4317
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License Number State | CO
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