| Family Peace Of Mind, Llc | |
|
2101 S Blackhawk St Ste 240 Aurora CO 80014-1475 | |
| (720) 316-5840 | |
| (720) 362-2435 |
| Full Name | Family Peace Of Mind, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2101 S Blackhawk St Ste 240, Aurora, Colorado |
| Authorized Official Name and Position | Irene G Ellis (OWNER) |
| Authorized Official Contact | 3038831082 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Peace Of Mind, Llc 2101 S Blackhawk St Ste 240 Aurora CO 80014-1475 Ph: (720) 316-5840 | Family Peace Of Mind, Llc 2101 S Blackhawk St Ste 240 Aurora CO 80014-1475 Ph: (720) 316-5840 |
| NPI Number | 1215298096 |
|---|---|
| Provider Enumeration Date | 06/07/2012 |
| Last Update Date | 04/01/2021 |
| Certification Date | 04/01/2021 |
| Medicare PECOS PAC ID | 5698076560 |
|---|---|
| Medicare Enrollment ID | O20151217002284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215298096 | NPI | - | NPPES |
| 61452769 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 3619 (Colorado) | Primary |
| Provider Name | Irene G Ellis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619138070 PECOS PAC ID: 6507167475 Enrollment ID: I20151217002356 |
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