| All Points Lodge Boulder | |
|
1360 Walnut St Ste 110 Boulder CO 80302-5399 | |
| (970) 693-0015 | |
| Not Available |
| Full Name | All Points Lodge Boulder |
|---|---|
| Speciality | Clinic/Center |
| Location | 1360 Walnut St Ste 110, Boulder, Colorado |
| Authorized Official Name and Position | Ashley Blair Elder (REVENUE CYCLE ADMINISTRATOR) |
| Authorized Official Contact | 7372471223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| All Points Lodge Boulder 2205 Cordillera Way Edwards CO 81632-6290 Ph: (970) 693-0015 | All Points Lodge Boulder 1360 Walnut St Ste 110 Boulder CO 80302-5399 Ph: (970) 693-0015 |
| NPI Number | 1982327334 |
|---|---|
| Provider Enumeration Date | 09/21/2022 |
| Last Update Date | 03/28/2023 |
| Medicare PECOS PAC ID | 5890169726 |
|---|---|
| Medicare Enrollment ID | O20230427001365 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982327334 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Kathleen Daly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568781698 PECOS PAC ID: 0042533952 Enrollment ID: I20141230000683 |
| Provider Name | Michelle D Presley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578812178 PECOS PAC ID: 2860632916 Enrollment ID: I20160411001849 |
| Provider Name | Adriana B De Julio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942509583 PECOS PAC ID: 4183928989 Enrollment ID: I20191112002189 |
| Provider Name | James Montgomery |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861469603 PECOS PAC ID: 7416007034 Enrollment ID: I20230821002597 |
| Provider Name | Omar Elhaj |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821103904 PECOS PAC ID: 0648289744 Enrollment ID: I20231114002528 |
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