Provider Demographics
NPI:1144802257
Name:MOBILE HEALTH TECHNOLOGY WITH SOLUTIONS
Entity Type:Organization
Organization Name:MOBILE HEALTH TECHNOLOGY WITH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:SUZAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PERREAULT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-449-6616
Mailing Address - Street 1:PO BOX 2621
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-2621
Mailing Address - Country:US
Mailing Address - Phone:720-449-6616
Mailing Address - Fax:720-792-3458
Practice Address - Street 1:12150 ANDREWS DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-4441
Practice Address - Country:US
Practice Address - Phone:720-449-6616
Practice Address - Fax:720-792-3458
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOBILE HEALTH TECHNOLOGY WITH SOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty