Healthcare Provider Details

I. General information

NPI: 1942195227
Provider Name (Legal Business Name): SPRINGBOK HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1318 W COLORADO AVE
COLORADO SPRINGS CO
80904-4023
US

IV. Provider business mailing address

1318 W COLORADO AVE
COLORADO SPRINGS CO
80904-4023
US

V. Phone/Fax

Practice location:
  • Phone: 719-766-8511
  • Fax:
Mailing address:
  • Phone: 719-766-8511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARK JANKELOW
Title or Position: CEO
Credential: PMHNP-BC
Phone: 719-766-8511