Provider Demographics
NPI:1497919666
Name:SAGE CREEK WELLNESS CENTER
Entity Type:Organization
Organization Name:SAGE CREEK WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-733-7444
Mailing Address - Street 1:4833 FRONT ST
Mailing Address - Street 2:UNIT C
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-7902
Mailing Address - Country:US
Mailing Address - Phone:720-733-7444
Mailing Address - Fax:
Practice Address - Street 1:4833 FRONT ST
Practice Address - Street 2:UNIT C
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-7902
Practice Address - Country:US
Practice Address - Phone:720-733-7444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CON/A261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation