Provider Demographics
NPI:1477189793
Name:ARETI COMPREHENSIVE PRIMARY CARE
Entity Type:Organization
Organization Name:ARETI COMPREHENSIVE PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANOS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:719-260-7302
Mailing Address - Street 1:4760 FLINTRIDGE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4264
Mailing Address - Country:US
Mailing Address - Phone:719-570-0386
Mailing Address - Fax:719-570-0386
Practice Address - Street 1:4760 FLINTRIDGE DR STE 250
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4264
Practice Address - Country:US
Practice Address - Phone:719-570-0386
Practice Address - Fax:719-570-0386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-18
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty