Provider Demographics
NPI:1457588568
Name:A WOMAN'S HEALING CENTER, LLC
Entity Type:Organization
Organization Name:A WOMAN'S HEALING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILGENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-419-1111
Mailing Address - Street 1:1006 LUKE ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4016
Mailing Address - Country:US
Mailing Address - Phone:970-419-1111
Mailing Address - Fax:970-407-0001
Practice Address - Street 1:1006 LUKE ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4016
Practice Address - Country:US
Practice Address - Phone:970-419-1111
Practice Address - Fax:970-407-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37957174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty