Provider Demographics
NPI:1790533123
Name:CLEAR HEART-LOVELAND LLC
Entity type:Organization
Organization Name:CLEAR HEART-LOVELAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MISCHO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:970-518-0741
Mailing Address - Street 1:3553 CLYDESDALE PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-7625
Mailing Address - Country:US
Mailing Address - Phone:970-900-1707
Mailing Address - Fax:970-237-3046
Practice Address - Street 1:3553 CLYDESDALE PKWY STE 104
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-7625
Practice Address - Country:US
Practice Address - Phone:970-900-1707
Practice Address - Fax:970-237-3046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology