Provider Demographics
NPI:1205660099
Name:SAUDADE SERVICES
Entity type:Organization
Organization Name:SAUDADE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:LOPES
Authorized Official - Last Name:DIPPON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:719-453-6244
Mailing Address - Street 1:802 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-4367
Mailing Address - Country:US
Mailing Address - Phone:719-453-6244
Mailing Address - Fax:
Practice Address - Street 1:425 W ROCKRIMMON BLVD STE 201
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-1767
Practice Address - Country:US
Practice Address - Phone:719-453-6244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty