Organization
WILD ROSE HEART LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIARA DEL ROSARIO RAFAEL B.S, M.A, LPCC (LEAD SOMATIC THERAPIST)
(970) 402-2246
Entity
Organization
Contact information
Practice address
1200 GRANT ST, LONGMONT, CO 80501-3710
(970) 402-2246
Mailing address
1200 GRANT ST, LONGMONT, CO 80501-3710
(970) 402-2246
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/18/2025
Last updated
07/18/2025
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