Provider Demographics
NPI:1023344454
Name:TOTAL HEALTH CARE
Entity type:Organization
Organization Name:TOTAL HEALTH CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:BRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, DMIN, LPC
Authorized Official - Phone:719-635-1825
Mailing Address - Street 1:1633 MEDICAL CENTER PT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8732
Mailing Address - Country:US
Mailing Address - Phone:719-634-1825
Mailing Address - Fax:719-634-1874
Practice Address - Street 1:1633 MEDICAL CENTER PT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8732
Practice Address - Country:US
Practice Address - Phone:719-634-1825
Practice Address - Fax:719-634-1874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5267251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health