Provider Demographics
NPI:1730845843
Name:BRAIN-BODY-SPIRIT- LLC
Entity type:Organization
Organization Name:BRAIN-BODY-SPIRIT- LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:720-470-7980
Mailing Address - Street 1:12128 W COOPER DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4861
Mailing Address - Country:US
Mailing Address - Phone:720-470-7980
Mailing Address - Fax:
Practice Address - Street 1:7 GALLINA PEAK
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508-1439
Practice Address - Country:US
Practice Address - Phone:720-470-7980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)