Provider Demographics
NPI:1457728123
Name:RADIANCE HEALTH INC
Entity Type:Organization
Organization Name:RADIANCE HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TABATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOEBEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-536-6177
Mailing Address - Street 1:833 W SOUTH BOULDER RD
Mailing Address - Street 2:UNIT C
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027
Mailing Address - Country:US
Mailing Address - Phone:303-536-6177
Mailing Address - Fax:
Practice Address - Street 1:833 W SOUTH BOULDER RD
Practice Address - Street 2:UNIT C
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2400
Practice Address - Country:US
Practice Address - Phone:303-536-6177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RADIANCE HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization