Organization
ONE ONE THOUSAND LLC
Active
Other names
The Untitled Mind Ketamine & Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM SHEELY (OWNER/NURSE PRACTITIONER)
(720) 437-9488
Entity
Organization
Contact information
Practice address
825 S BROADWAY UNIT 10, BOULDER, CO 80305
(720) 437-9488
Mailing address
1074 BEREA DRIVE, BOULDER, CO 80305
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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