Provider Demographics
NPI:1184225336
Name:WELLCOVA HEALTH SERVICES
Entity Type:Organization
Organization Name:WELLCOVA HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLNA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:970-924-0570
Mailing Address - Street 1:410 ACOMA ST UNIT 106
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-5141
Mailing Address - Country:US
Mailing Address - Phone:276-233-5063
Mailing Address - Fax:
Practice Address - Street 1:90 MADISON ST STE 704
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5416
Practice Address - Country:US
Practice Address - Phone:970-924-0570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)