| De Novo Wellness Center Llc | |
|
1005 N 10th St Canon City CO 81212-3035 | |
| (719) 400-8836 | |
| Not Available |
| Full Name | De Novo Wellness Center Llc |
|---|---|
| Speciality | Counselor |
| Location | 1005 N 10th St, Canon City, Colorado |
| Authorized Official Name and Position | Amanda Union (OWNER) |
| Authorized Official Contact | 7194008836 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| De Novo Wellness Center Llc 1005 N 10th St Canon City CO 81212-3035 Ph: (719) 400-8836 | De Novo Wellness Center Llc 1005 N 10th St Canon City CO 81212-3035 Ph: (719) 400-8836 |
| NPI Number | 1417718230 |
|---|---|
| Provider Enumeration Date | 01/18/2024 |
| Last Update Date | 01/18/2024 |
| Certification Date | 01/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417718230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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