Provider Demographics
NPI:1346057783
Name:MAX WELLNESS LLC
Entity type:Organization
Organization Name:MAX WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAXWELL
Authorized Official - Middle Name:VAGN
Authorized Official - Last Name:TUREK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW AND LAC
Authorized Official - Phone:970-458-5138
Mailing Address - Street 1:2590 WELTON ST
Mailing Address - Street 2:#515
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205
Mailing Address - Country:US
Mailing Address - Phone:970-458-5138
Mailing Address - Fax:
Practice Address - Street 1:2590 WELTON ST
Practice Address - Street 2:#515
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-3773
Practice Address - Country:US
Practice Address - Phone:970-458-5138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-17
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000238359Medicaid