Provider Demographics
NPI:1164252359
Name:OUTWARD IN YOGA LLC
Entity type:Organization
Organization Name:OUTWARD IN YOGA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEATHERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:720-840-6841
Mailing Address - Street 1:8083 W 51ST PL UNIT 104
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-4351
Mailing Address - Country:US
Mailing Address - Phone:720-840-6841
Mailing Address - Fax:
Practice Address - Street 1:5810 W 38TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80212-7100
Practice Address - Country:US
Practice Address - Phone:303-997-2864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health