Organization
DE NOVO WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA UNION LPC (OWNER)
(719) 400-8836
Entity
Organization
Contact information
Practice address
1005 N 10TH ST, CANON CITY, CO 81212-3035
(719) 400-8836
Mailing address
1005 N 10TH ST, CANON CITY, CO 81212-3035
(719) 400-8836
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/18/2024
Last updated
01/18/2024
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