Healthcare Provider Details

I. General information

NPI: 1932049764
Provider Name (Legal Business Name): TILA PROMISE PEDIATRIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 PUCKET CIR
COLORADO SPRINGS CO
80911-3326
US

IV. Provider business mailing address

3472 RESEARCH PKWY STE 104
COLORADO SPRINGS CO
80920-1066
US

V. Phone/Fax

Practice location:
  • Phone: 201-241-0079
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: AMARI MAJOR
Title or Position: OWNER
Credential: BACB
Phone: 201-241-0079