| Inner Radiance Llc | |
|
4150 Darley Ave Ste 6 Boulder CO 80305-6537 | |
| (720) 441-2850 | |
| Not Available |
| Full Name | Inner Radiance Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4150 Darley Ave Ste 6, Boulder, Colorado |
| Authorized Official Name and Position | Mark Swart (OWNER) |
| Authorized Official Contact | 7194801841 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Radiance Llc Po Box 3413 Boulder CO 80307-3413 Ph: () - | Inner Radiance Llc 4150 Darley Ave Ste 6 Boulder CO 80305-6537 Ph: (720) 441-2850 |
| NPI Number | 1093315277 |
|---|---|
| Provider Enumeration Date | 10/28/2020 |
| Last Update Date | 10/28/2020 |
| Certification Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093315277 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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