Organization
MARK S. GRIMM, LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK S. GRIMM LCSW (PRESIDENT)
(720) 841-1742
Entity
Organization
Contact information
Practice address
355 ALBION ST, DENVER, CO 80220-4912
(720) 841-1742
Mailing address
355 ALBION ST, DENVER, CO 80220-4912
(720) 841-1742
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
985017
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07101553
—
CO
Enumeration date
06/14/2013
Last updated
06/14/2013
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