1710810452 NPI number — INTROSPECTIVE FAMILY WELLNESS DENVER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710810452 NPI number — INTROSPECTIVE FAMILY WELLNESS DENVER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTROSPECTIVE FAMILY WELLNESS DENVER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710810452
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/08/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
990 W 41ST AVE UNIT 305
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80211-2579
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
224-619-2350
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3401 QUEBEC ST STE 4500
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80207-2310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
224-619-2350
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/03/2026

Additional Information

Authorized Official

Authorized Official Last Name:
STANISH
Authorized Official First Name:
NATALIE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/DIRECTOR
Authorized Official Telephone Number:
224-619-2350

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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