Provider Demographics
NPI:1396577177
Name:DENVER WELLNESS ASSOCIATES
Entity type:Organization
Organization Name:DENVER WELLNESS ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:THEOBALD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-724-3668
Mailing Address - Street 1:300 S JACKSON ST STE 240
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3131
Mailing Address - Country:US
Mailing Address - Phone:720-724-3668
Mailing Address - Fax:
Practice Address - Street 1:350 INTERLOCKEN BLVD STE 250
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-8017
Practice Address - Country:US
Practice Address - Phone:720-724-3668
Practice Address - Fax:720-598-0480
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENVER WELLNESS ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty