Provider Demographics
NPI:1982919809
Name:BIENESTAR GROUP
Entity Type:Organization
Organization Name:BIENESTAR GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WINKLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-246-8449
Mailing Address - Street 1:4860 CHAMBERS RD
Mailing Address - Street 2:SUITE 256
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-5152
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4860 CHAMBERS RD
Practice Address - Street 2:SUITE 256
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-5152
Practice Address - Country:US
Practice Address - Phone:719-246-8449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19738208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty