| Accent On Life, Llc | |
|
1335 Phay Ave Suite H Canon City CO 81212-2334 | |
| (719) 784-7522 | |
| (719) 269-1730 |
| Full Name | Accent On Life, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1335 Phay Ave, Canon City, Colorado |
| Authorized Official Name and Position | Terri Gorman (SOLE PROPRIETOR) |
| Authorized Official Contact | 7197847522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Accent On Life, Llc Po Box 681 Penrose CO 81240-0681 Ph: (719) 784-7522 | Accent On Life, Llc 1335 Phay Ave Suite H Canon City CO 81212-2334 Ph: (719) 784-7522 |
| NPI Number | 1245536168 |
|---|---|
| Provider Enumeration Date | 02/10/2011 |
| Last Update Date | 02/10/2011 |
| Medicare PECOS PAC ID | 2062698038 |
|---|---|
| Medicare Enrollment ID | O20110510000171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245536168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 993001 (Colorado) | Primary |
| Provider Name | Terri L Gorman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114258670 PECOS PAC ID: 9032395009 Enrollment ID: I20110516000009 |
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