Provider Demographics
NPI:1750190245
Name:THORNWOODWELLNESSLLC
Entity type:Organization
Organization Name:THORNWOODWELLNESSLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:BRUNICK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:303-908-5560
Mailing Address - Street 1:620 FRONT RANGE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4052
Mailing Address - Country:US
Mailing Address - Phone:303-908-5560
Mailing Address - Fax:
Practice Address - Street 1:1075 W HORSETOOTH RD UNIT 200
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-5984
Practice Address - Country:US
Practice Address - Phone:303-908-5560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THORNWOOD WELLNESS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)