Provider Demographics
NPI:1093259053
Name:HARMONIZED BRAIN CENTERS
Entity Type:Organization
Organization Name:HARMONIZED BRAIN CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BRAIN HEALTH SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DALLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-661-6422
Mailing Address - Street 1:2149 N ACADEMY BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1507
Mailing Address - Country:US
Mailing Address - Phone:719-661-6422
Mailing Address - Fax:719-213-2011
Practice Address - Street 1:8719 E DRY CREEK RD
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2814
Practice Address - Country:US
Practice Address - Phone:719-661-6422
Practice Address - Fax:719-213-2011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-10
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEGGroup - Multi-Specialty