# CLEMENTINE HEALTH AND WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902632904
- **Authorized official:** KEENAN GRIEGO (NP)
- **Authorized official phone:** (719) 204-3429

## Contact information

- **Practice address:** 225 E CHEYENNE MOUNTAIN BLVD STE 100, COLORADO SPRINGS, CO 80906-3700
- **Practice address phone:** (719) 204-3429
- **Mailing address:** 225 E CHEYENNE MOUNTAIN BLVD STE 100, COLORADO SPRINGS, CO 80906-3700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/09/2024
- **Last updated:** 09/09/2024