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Organization
SAGE SPACE RETREAT LLC
Active
Organization
SAGE SPACE RETREAT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELENA GEORGOUSES LCSW (CO-OWNER/CLINICAL SOCIAL WORKER)
(970) 471-2297
Entity
Organization
Contact information
Practice address
8536 FOXHAVEN DR., LONGMONT, CO 80503-8698
(720) 963-8111
Mailing address
8536 FOXHAVEN DR., LONGMONT, CO 80503-8698
(970) 471-2297
(970) 476-5299
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/05/2024
Last updated
03/05/2024
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