Organization
SOUTH TABLE WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN RIPPERGER-HARRELL LCSW (MANAGING MEMBER)
(720) 324-7939
Entity
Organization
Contact information
Practice address
2550 YOUNGFIELD ST # 4, LAKEWOOD, CO 80215-1033
(720) 324-7939
Mailing address
2903 LOOKOUT VIEW DR, GOLDEN, CO 80401-2521
(720) 324-7939
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/20/2022
Last updated
02/03/2024
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