Provider Demographics
NPI:1902958358
Name:GARY W. LEE
Entity Type:Organization
Organization Name:GARY W. LEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-296-2244
Mailing Address - Street 1:2150 CURTIS ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2519
Mailing Address - Country:US
Mailing Address - Phone:303-296-2244
Mailing Address - Fax:303-296-1709
Practice Address - Street 1:2150 CURTIS ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2519
Practice Address - Country:US
Practice Address - Phone:303-296-2244
Practice Address - Fax:303-296-1709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-578251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care