Provider Demographics
NPI:1801574900
Name:NATHAN LANE MONTGOMERY FOUNDATION, INC.
Entity type:Organization
Organization Name:NATHAN LANE MONTGOMERY FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-319-3079
Mailing Address - Street 1:3570 E 12TH AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-3431
Mailing Address - Country:US
Mailing Address - Phone:720-319-3079
Mailing Address - Fax:
Practice Address - Street 1:3570 E 12TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-3431
Practice Address - Country:US
Practice Address - Phone:720-319-3079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-07
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty