Provider Demographics
NPI:1003299488
Name:JOURNEY TOWARDS AWAKENING
Entity Type:Organization
Organization Name:JOURNEY TOWARDS AWAKENING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BRISSON
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:303-502-7570
Mailing Address - Street 1:3815 PASEO DEL PRADO
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1521
Mailing Address - Country:US
Mailing Address - Phone:303-526-8642
Mailing Address - Fax:
Practice Address - Street 1:10090 GARRISON ST STE 101
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-3894
Practice Address - Country:US
Practice Address - Phone:303-502-7570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-03
Last Update Date:2015-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000103261Q00000X
CO1119261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO175F00000XOtherNATUROPATHIC DOCTOR
CO171100000XOtherACUPUNCTURIST