Healthcare Provider Details

I. General information

NPI: 1619885829
Provider Name (Legal Business Name): HARBOR HOPE COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 ROYAL GORGE BLVD STE 225
CANON CITY CO
81212-6709
US

IV. Provider business mailing address

831 ROYAL GORGE BLVD STE 225
CANON CITY CO
81212-6709
US

V. Phone/Fax

Practice location:
  • Phone: 710-304-6468
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: JENIFER BURBANK
Title or Position: PRESIDENT
Credential: LPC
Phone: 719-671-1036