Organization
ALDER GROVE WELLNESS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY VAUSE DNP (PSYCHIATRIC NURSE PRACTITIONER)
(720) 331-6899
Entity
Organization
Contact information
Practice address
90 MADISON ST, SUITE 400, DENVER, CO 80206-5418
(720) 331-6899
(720) 889-9496
Mailing address
90 MADISON ST, SUITE 400, DENVER, CO 80206-5418
(720) 331-6899
(720) 889-9496
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
00001020
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
164461
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58008314
—
CO
Enumeration date
03/11/2014
Last updated
03/11/2014
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