Willow Grove Mental Health, Inc. | |
14211 E 4th Ave Aurora CO 80011-8736 | |
(720) 262-9100 | |
(720) 262-9101 |
Full Name | Willow Grove Mental Health, Inc. |
---|---|
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 14211 E 4th Ave, Aurora, Colorado |
Authorized Official Name and Position | Mary Elizabeth Waggoner (PRESIDENT) |
Authorized Official Contact | 7202629100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Willow Grove Mental Health, Inc. 14211 E 4th Ave # 3-138 Aurora CO 80011-8736 Ph: (720) 262-9100 | Willow Grove Mental Health, Inc. 14211 E 4th Ave Aurora CO 80011-8736 Ph: (720) 262-9100 |
NPI Number | 1023502549 |
---|---|
Provider Enumeration Date | 06/18/2018 |
Last Update Date | 10/30/2020 |
Certification Date | 10/30/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023502549 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 09923992 (Colorado) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 0770900 (Colorado) | Primary |
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