Provider Demographics
NPI:1215549886
Name:BRAIN AND BODY INSIGHTS
Entity Type:Organization
Organization Name:BRAIN AND BODY INSIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BECKIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GRGICH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:719-344-8779
Mailing Address - Street 1:14241 S REDWOOD RD STE 153
Mailing Address - Street 2:
Mailing Address - City:BLUFFDALE
Mailing Address - State:UT
Mailing Address - Zip Code:84065-5223
Mailing Address - Country:US
Mailing Address - Phone:801-819-8719
Mailing Address - Fax:719-313-9210
Practice Address - Street 1:14960 WOODCARVER RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-2370
Practice Address - Country:US
Practice Address - Phone:719-344-8779
Practice Address - Fax:719-313-9210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health