Provider Demographics
NPI:1669790572
Name:WIN HEALTH INSTITUTE, LLC
Entity type:Organization
Organization Name:WIN HEALTH INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-279-4099
Mailing Address - Street 1:P.O. BOX 4618
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BASALT
Mailing Address - State:CO
Mailing Address - Zip Code:81621
Mailing Address - Country:US
Mailing Address - Phone:970-279-4099
Mailing Address - Fax:970-279-4106
Practice Address - Street 1:110 MIDLAND AVENUE
Practice Address - Street 2:SUITE 2
Practice Address - City:BASALT
Practice Address - State:CO
Practice Address - Zip Code:81621
Practice Address - Country:US
Practice Address - Phone:970-279-4099
Practice Address - Fax:970-279-4106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-17
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1215083241302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization