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NPI Code Detail

MEDICARE: PASADENA VILLA COLORADO, LLC

MEDICARE: PASADENA VILLA COLORADO, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1245116094
Entity Type Code : Organization
Provider Name (Legal Business Name) : PASADENA VILLA COLORADO, LLC
Provider Business Mailing Address
First Line : 720 COOL SPRINGS BLVD STE 550
Second Line :
City : FRANKLIN
State : TN
Zip : 37067-2645
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1155 KELLY JOHNSON BLVD STE 100
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-3957
Country : US
Telephone Number : 615-864-8145
Fax Number :
Authorized Official
Title or Position : CFO
Name : BENJAMIN RUSH BRADY
Credential :
Telephone Number : 615-864-8145
Provider Enumeration Date : 08/14/2025
Last Update Date : 04/15/2026

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Directions to “PASADENA VILLA COLORADO, LLC ” Practice Location

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