| Mato Sapa Trails Llc | |
|
710 South St Castle Rock CO 80104-2621 | |
| (303) 949-1087 | |
| Not Available |
| Full Name | Mato Sapa Trails Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 710 South St, Castle Rock, Colorado |
| Authorized Official Name and Position | Jennifer Elliott (OWNER) |
| Authorized Official Contact | 3039491087 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mato Sapa Trails Llc 710 South St Castle Rock CO 80104-2621 Ph: () - | Mato Sapa Trails Llc 710 South St Castle Rock CO 80104-2621 Ph: (303) 949-1087 |
| NPI Number | 1538891817 |
|---|---|
| Provider Enumeration Date | 06/27/2022 |
| Last Update Date | 06/27/2022 |
| Certification Date | 06/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538891817 | NPI | - | NPPES |
| LPC.0001519 | Other | CO | DORA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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