Organization
LA LUNA CENTER, LLC
Active
Organization
LA LUNA CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM CRISCO (MANAGER)
(720) 470-3345
Entity
Organization
Contact information
Practice address
2020 CARIBOU DR STE 201, FORT COLLINS, CO 80525-4352
(970) 282-8282
(303) 200-7098
Mailing address
2020 CARIBOU DR STE 201, FORT COLLINS, CO 80525-4352
(970) 282-8282
(303) 200-7098
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Enumeration date
12/17/2020
Last updated
12/17/2020
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