Provider Demographics
NPI:1720326515
Name:TATE RECONSTRUCTION SERVICES
Entity type:Organization
Organization Name:TATE RECONSTRUCTION SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:B
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, BCN
Authorized Official - Phone:303-968-4048
Mailing Address - Street 1:PO BOX 771
Mailing Address - Street 2:
Mailing Address - City:INDIAN HILLS
Mailing Address - State:CO
Mailing Address - Zip Code:80454-0771
Mailing Address - Country:US
Mailing Address - Phone:303-968-4048
Mailing Address - Fax:303-301-8342
Practice Address - Street 1:7500 W MISSISSIPPI AVE
Practice Address - Street 2:SUITE B-160
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-4550
Practice Address - Country:US
Practice Address - Phone:303-968-4048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health