| Maura Stack Oden Llc | |
|
1309 Oak Way Ave Glenwood Springs CO 81601-4049 | |
| (720) 670-9046 | |
| Not Available |
| Full Name | Maura Stack Oden Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1309 Oak Way Ave, Glenwood Springs, Colorado |
| Authorized Official Name and Position | Maura Wamsley (OWNER) |
| Authorized Official Contact | 7206709046 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maura Stack Oden Llc 1309 Oak Way Ave Glenwood Springs CO 81601-4049 Ph: () - | Maura Stack Oden Llc 1309 Oak Way Ave Glenwood Springs CO 81601-4049 Ph: (720) 670-9046 |
| NPI Number | 1194186148 |
|---|---|
| Provider Enumeration Date | 03/17/2016 |
| Last Update Date | 07/23/2021 |
| Certification Date | 07/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194186148 | NPI | - | NPPES |
| 64185044 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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