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NPI Code Detail

MEDICARE: SHAROL WELLS C.A.C. III

MEDICARE: SHAROL WELLS C.A.C. III
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
1101YA0400XAddiction (Substance Use Disorder) Counselor5302CO

General Provider Information

NPI Number : 1164724894
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAROL WELLS C.A.C. III
Provider Business Mailing Address
First Line : 7251 E 49TH AVE
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-4714
Country : US
Telephone Number : 303-321-2533
Fax Number :
Provider Business Practice Location Address
First Line : 7251 E 49TH AVE
Second Line :
City : COMMERCE CITY
State : CO
Zip : 80022-4714
Country : US
Telephone Number : 303-321-2533
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2010
Last Update Date : 12/01/2010

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