Provider Demographics
NPI:1912725961
Name:UNHARNESSED POTENTIAL
Entity type:Organization
Organization Name:UNHARNESSED POTENTIAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SLIVKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-269-6120
Mailing Address - Street 1:8655 KANE RD
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-3339
Mailing Address - Country:US
Mailing Address - Phone:913-269-6120
Mailing Address - Fax:719-434-8867
Practice Address - Street 1:8655 KANE RD
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-3339
Practice Address - Country:US
Practice Address - Phone:913-269-6120
Practice Address - Fax:719-434-8867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty