Organization
POWER-UP PERFORMANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL HARDIN M.A., LPC, NCC (LEAD CLINICIAN)
(303) 547-0743
Entity
Organization
Contact information
Practice address
631 S DEPEW ST, LAKEWOOD, CO 80226-4845
(303) 547-0743
Mailing address
631 S DEPEW ST, LAKEWOOD, CO 80226-4845
(303) 547-0743
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000145803
—
CO
Enumeration date
05/12/2017
Last updated
05/12/2017
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