Provider Demographics
NPI:1821359944
Name:KWALITAS GROUP LLC
Entity Type:Organization
Organization Name:KWALITAS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FLORIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EZUI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-544-7555
Mailing Address - Street 1:PO BOX 202971
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-8971
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14211 E 4TH AVE
Practice Address - Street 2:SUITE 3-225
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8736
Practice Address - Country:US
Practice Address - Phone:720-544-7555
Practice Address - Fax:720-835-0045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2016-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health