Provider Demographics
NPI:1669626057
Name:INDULGE CENTER FOR BEAUTY AND HEALING, PLLC
Entity Type:Organization
Organization Name:INDULGE CENTER FOR BEAUTY AND HEALING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:LEN
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L, CCI
Authorized Official - Phone:970-282-0258
Mailing Address - Street 1:2807 DUNBAR AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-2279
Mailing Address - Country:US
Mailing Address - Phone:970-282-0258
Mailing Address - Fax:
Practice Address - Street 1:2807 DUNBAR AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-2279
Practice Address - Country:US
Practice Address - Phone:970-282-0258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty