Organization
GRACE MOUNTAIN HEALTH & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY W LEWIS (CO-OWNER)
(304) 676-9947
Entity
Organization
Contact information
Practice address
500 SAN JUAN ST, TRINIDAD, CO 81082-2517
(304) 676-9947
Mailing address
500 SAN JUAN ST, TRINIDAD, CO 81082-2517
Taxonomy
Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
11/04/2025
Last updated
11/04/2025
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