Provider Demographics
NPI:1730813643
Name:NEW LEAF PEER 2 PEER, LLC
Entity type:Organization
Organization Name:NEW LEAF PEER 2 PEER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAYDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHARIBYAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-382-0011
Mailing Address - Street 1:11520 E 162ND DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-7684
Mailing Address - Country:US
Mailing Address - Phone:720-382-0011
Mailing Address - Fax:
Practice Address - Street 1:11520 E 162ND DR
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80602-7684
Practice Address - Country:US
Practice Address - Phone:720-382-0011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-15
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No333600000XSuppliersPharmacyGroup - Multi-Specialty