Healthcare Provider Details

I. General information

NPI: 1093654105
Provider Name (Legal Business Name): ROCKY MOUNTAIN YOUTH MEDICAL & NURSING CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 COTTONWOOD DR
BASALT CO
81621-8345
US

IV. Provider business mailing address

151 COTTONWOOD DR
BASALT CO
81621-8345
US

V. Phone/Fax

Practice location:
  • Phone: 332-330-3903
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State

VIII. Authorized Official

Name: PAUL BROWN
Title or Position: OWNER
Credential:
Phone: 332-330-3903