Cirque Meadow Psychiatry Virginia Caryl Mack Sole Mbr
LBN: Cirque Meadow Psychiatry
Cirque Meadow Psychiatry Virginia Caryl Mack Sole Mbr is an health care organization with primary practice located at Cirque Meadow Psychiatry 211 West Myrte Street, Suite 207, Fort Collins CO 80521-2971. The organization recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Child & Adolescent. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is the primary health care specialty.
Cirque Meadow Psychiatry can be contacted via phone (360) 621-1409, or through Mack, Virginia via phone (360) 621-1409.
Contact Information
Primary practice address
Cirque Meadow Psychiatry 211 West Myrte Street, Suite 207
Fort Collins CO 80521-2971
Phone: (360) 621-1409
Fax: (848) 213-0217
Website:
Authorized official contact:
Name: Mack, Virginia Advanced Practice Registered Nurse (APRN)
Phone: (360) 621-1409
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Child & Adolescent | 364SP0807X |
Profile Details
| NPI number | 1578184230 |
|---|---|
| LBN Legal business name | Cirque Meadow Psychiatry |
| DBA Doing business as | Cirque Meadow Psychiatry Virginia Caryl Mack Sole Mbr |
| Authorized official | Mack, Virginia Advanced Practice Registered Nurse (APRN) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 4th, 2020 |
| Last updated | Jul 29th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578184230 | NPPES |
| Colorado | Other | APN0990068-NP | MEDICAL LICENSE |
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