| Inner Refuge Therapy | |
|
1702 Wabash Ave Pueblo CO 81004-3341 | |
| (719) 306-1765 | |
| Not Available |
| Full Name | Inner Refuge Therapy |
|---|---|
| Speciality | Clinic/Center |
| Location | 1702 Wabash Ave, Pueblo, Colorado |
| Authorized Official Name and Position | Rachel Donohue-dupler (OWNER/CEO) |
| Authorized Official Contact | 7193061765 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Refuge Therapy 1702 Wabash Ave Pueblo CO 81004-3341 Ph: () - | Inner Refuge Therapy 1702 Wabash Ave Pueblo CO 81004-3341 Ph: (719) 306-1765 |
| NPI Number | 1821772963 |
|---|---|
| Provider Enumeration Date | 06/09/2023 |
| Last Update Date | 06/09/2023 |
| Certification Date | 06/09/2023 |
| Medicare PECOS PAC ID | 2163865189 |
|---|---|
| Medicare Enrollment ID | O20240207000813 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821772963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Rachel Donohue-dupler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720593395 PECOS PAC ID: 1153751094 Enrollment ID: I20200417000359 |
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