Provider Demographics
NPI:1013747963
Name:HOLISTIC ADHD TREATMENT (HAT CLINIC), LLC
Entity type:Organization
Organization Name:HOLISTIC ADHD TREATMENT (HAT CLINIC), LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:AMBER
Authorized Official - Last Name:STIDHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-592-1193
Mailing Address - Street 1:1020 PIONEER LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-1751
Mailing Address - Country:US
Mailing Address - Phone:719-592-1193
Mailing Address - Fax:303-535-2307
Practice Address - Street 1:1802 CHAPEL HILLS DR STE D
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3736
Practice Address - Country:US
Practice Address - Phone:719-428-7136
Practice Address - Fax:303-535-2307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)