Sage Space Retreat LLC

NPI #1043077092 in Longmont, Colorado

Provider Information

NPI Number: 1043077092
Entity Type: Organization
Organization Name: Sage Space Retreat LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Mar 5, 2024
Last Updated: Mar 5, 2024

Practice Location

Address: 8536 FOXHAVEN DR.
City: Longmont
State: Colorado
ZIP Code: 80503-8698
Phone: (720) 963-8111

Authorized Official

Name: MS. ELENA GEORGOUSES, LCSW
Title: CO-OWNER/CLINICAL SOCIAL WORKER
Phone: (970) 471-2297

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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