Organization
JADE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL MARIE GALLEGOS MFTC, LPCC (CLINICAL THERAPIST)
(833) 523-3669
Entity
Organization
Contact information
Practice address
255 S ROUTT ST STE 265, LAKEWOOD, CO 80228-2271
(833) 523-3669
Mailing address
1480 S DEPEW ST, LAKEWOOD, CO 80232-5860
(720) 965-7219
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053957407
—
CO
Enumeration date
04/06/2020
Last updated
04/06/2020
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