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Organization
MIDDLE GROUND
Active
Organization
MIDDLE GROUND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES L LENTZ LPC (OWNER)
(719) 250-6526
Entity
Organization
Contact information
Practice address
1335 PHAY AVE, SUITE E, CANON CITY, CO 81212-2334
(719) 250-6526
Mailing address
1335 PHAY AVE, SUITE E, CANON CITY, CO 81212-2334
(719) 250-6526
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2529
CO
Other
Enumeration date
05/18/2010
Last updated
05/18/2010
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