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NPI Code Detail

MEDICARE: ENHANCED LIFE COUNSELING, LLC

MEDICARE: ENHANCED LIFE COUNSELING, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor4551CO

General Provider Information

NPI Number : 1134675416
Entity Type Code : Organization
Provider Name (Legal Business Name) : ENHANCED LIFE COUNSELING, LLC
Provider Business Mailing Address
First Line : 6755 EARL DR STE 209
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-1039
Country : US
Telephone Number : 719-310-0602
Fax Number : 719-282-1216
Provider Business Practice Location Address
First Line : 6755 EARL DR STE 209
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-1039
Country : US
Telephone Number : 719-310-0602
Fax Number : 719-282-1216
Authorized Official
Title or Position : OWNER
Name : VASTI HOLSTUN
Credential :
Telephone Number : 719-310-0602
Provider Enumeration Date : 08/28/2016
Last Update Date : 04/23/2024

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Directions to “ENHANCED LIFE COUNSELING, LLC ” Practice Location

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