| La Luna Center, Llc | |
|
3002 Bluff St Suite 200 Boulder CO 80301-2162 | |
| (720) 470-0010 | |
| (303) 200-7098 |
| Full Name | La Luna Center, Llc |
|---|---|
| Speciality | Psychologist - Group Psychotherapy |
| Location | 3002 Bluff St, Boulder, Colorado |
| Authorized Official Name and Position | William Crisco (BUSINESS MANAGER) |
| Authorized Official Contact | 7204700010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Luna Center, Llc 3002 Bluff St Suite 200 Boulder CO 80301-2162 Ph: (720) 470-0010 | La Luna Center, Llc 3002 Bluff St Suite 200 Boulder CO 80301-2162 Ph: (720) 470-0010 |
| NPI Number | 1215054218 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 12/17/2020 |
| Certification Date | 12/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215054218 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | (* (Not Available)) | Primary |
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