STACY GREEN ENTERPRISES LLC NPI 1871262253

NPI Information

NPI: 1871262253
Provider Name: STACY GREEN ENTERPRISES, LLC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
3985 WONDERLAND HILL AVE STE 107
BOULDER, CO
ZIP 80304
Phone: (303) 717-2521
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STACY GREEN ENTERPRISES, LLC is a health service clinic center in Boulder, CO. STACY GREEN ENTERPRISES, LLC NPI is 1871262253. The provider is registered as an organization entity type.

The provider's business location address is:

3985 WONDERLAND HILL AVE STE 107
BOULDER, CO
ZIP 80304-038
Phone: (303) 717-2521

The provider's authorized official is Stacy Green .
The authorized official title is Owner and has the following contact phone number (303) 717-2521.

The enumeration date for this NPI number is 9/9/2021 and was last updated on 9/9/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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