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Individual

MRS. RACHEL R FAHNESTOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
12751 W 56TH PL, ARVADA, CO 80002-1327
(303) 424-4136
Mailing address
4851 INDEPENDENCE ST, SUITE 200, WHEAT RIDGE, CO 80033-6715
(303) 425-0300
(303) 432-5071

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary

Other

Enumeration date
12/18/2007
Last updated
12/18/2007
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