Provider Demographics
NPI:1891092946
Name:THE RESOURCE EXCHANGE
Entity Type:Organization
Organization Name:THE RESOURCE EXCHANGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLPA
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BOGDANOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-375-5301
Mailing Address - Street 1:7914 CAMPGROUND DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-4511
Mailing Address - Country:US
Mailing Address - Phone:719-375-5301
Mailing Address - Fax:
Practice Address - Street 1:7914 CAMPGROUND DR
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-4511
Practice Address - Country:US
Practice Address - Phone:719-375-5301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0481396174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0481396OtherSTATE SLPA LICENSE