| Melissa Riesling LLC | |
|
1864 Woodmoor Dr Ste 208 Monument CO 80132-9085 | |
| (719) 359-2525 | |
| Not Available |
| Full Name | Melissa Riesling LLC |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1864 Woodmoor Dr Ste 208, Monument, Colorado |
| Authorized Official Name and Position | Melissa R Riesling (PRESIDENT) |
| Authorized Official Contact | 7193592525 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Melissa Riesling LLC 20431 Bald Mountain Ct Monument CO 80132-9310 Ph: (719) 359-2525 | Melissa Riesling LLC 1864 Woodmoor Dr Ste 208 Monument CO 80132-9085 Ph: (719) 359-2525 |
| NPI Number | 1184185068 |
|---|---|
| Provider Enumeration Date | 03/25/2019 |
| Last Update Date | 03/25/2019 |
| Medicare PECOS PAC ID | 3577901966 |
|---|---|
| Medicare Enrollment ID | O20240404000636 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184185068 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (NU) | Primary |
| Provider Name | Melissa R Riesling |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275875676 PECOS PAC ID: 4486092871 Enrollment ID: I20240404000730 |
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