Provider Demographics
NPI:1467779348
Name:DENVER COMMUNITY WELLNESS
Entity Type:Organization
Organization Name:DENVER COMMUNITY WELLNESS
Other - Org Name:BERKELEY COMMUNITY ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:303-351-1228
Mailing Address - Street 1:4022 TENNYSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-2104
Mailing Address - Country:US
Mailing Address - Phone:303-351-1228
Mailing Address - Fax:
Practice Address - Street 1:4022 TENNYSON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-2104
Practice Address - Country:US
Practice Address - Phone:303-351-1228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1435171100000X
CO1511171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty