Organization
BACK TO LIFE COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID ALLEN PACKARD CAC III (OWNER DIRECTOR)
(303) 651-2554
Entity
Organization
Contact information
Practice address
500 9TH AVE STE 10, LONGMONT, CO 80501-4599
(303) 651-2554
(303) 485-2477
Mailing address
500 9TH AVE STE 10, LONGMONT, CO 80501-4599
(303) 651-2554
(303) 485-2477
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1751-01
CO
Other
Enumeration date
03/24/2016
Last updated
03/24/2016
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