| Rocky Mountain Psychiatric Associates, Llc | |
|
75 Manhattan Dr Ste 204 Boulder CO 80303-4252 | |
| (303) 569-8858 | |
| (303) 647-9214 |
| Full Name | Rocky Mountain Psychiatric Associates, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 75 Manhattan Dr Ste 204, Boulder, Colorado |
| Authorized Official Name and Position | Gwendolyn Gregory Grace (PSYCHIATRIST) |
| Authorized Official Contact | 3035698858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rocky Mountain Psychiatric Associates, Llc 75 Manhattan Dr Ste 204 Boulder CO 80303-4252 Ph: (303) 569-8858 | Rocky Mountain Psychiatric Associates, Llc 75 Manhattan Dr Ste 204 Boulder CO 80303-4252 Ph: (303) 569-8858 |
| NPI Number | 1023726825 |
|---|---|
| Provider Enumeration Date | 11/10/2022 |
| Last Update Date | 11/10/2022 |
| Certification Date | 11/10/2022 |
| Medicare PECOS PAC ID | 7416327788 |
|---|---|
| Medicare Enrollment ID | O20221230002108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023726825 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Emily E Bucy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467552117 PECOS PAC ID: 9537138706 Enrollment ID: I20080208000424 |
| Provider Name | Gwendolyn G Grace |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194925594 PECOS PAC ID: 4880871763 Enrollment ID: I20110601000419 |
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