Provider Demographics
NPI:1235599085
Name:MAMA NURTURE WELLNESS
Entity Type:Organization
Organization Name:MAMA NURTURE WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:DEMPSEY
Authorized Official - Suffix:
Authorized Official - Credentials:CD(DONA), BCTMB, CBS
Authorized Official - Phone:256-698-2261
Mailing Address - Street 1:1888 S JACKSON ST
Mailing Address - Street 2:102
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3924
Mailing Address - Country:US
Mailing Address - Phone:256-698-2261
Mailing Address - Fax:
Practice Address - Street 1:1888 S JACKSON ST
Practice Address - Street 2:102
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3924
Practice Address - Country:US
Practice Address - Phone:256-698-2261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care