Organization
INNER LIFE ADVENTURES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES S HANCOCK LPC (LPC, OWNER)
(970) 556-4095
Entity
Organization
Contact information
Practice address
343 W DRAKE RD STE 200, FORT COLLINS, CO 80526-2880
(970) 829-0478
Mailing address
343 W DRAKE RD STE 200, FORT COLLINS, CO 80526-2880
(970) 829-0478
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
04/15/2021
Last updated
04/15/2021
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