Healthcare Provider Details

I. General information

NPI: 1043260243
Provider Name (Legal Business Name): DIVERSUS HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 RUSKIN DR
COLORADO SPRINGS CO
80910-2522
US

IV. Provider business mailing address

220 RUSKIN DR
COLORADO SPRINGS CO
80910-2522
US

V. Phone/Fax

Practice location:
  • Phone: 719-572-6100
  • Fax: 719-572-6080
Mailing address:
  • Phone: 719-572-6100
  • Fax: 719-447-4792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: GENE CONTRERAS
Title or Position: VP FINANCE
Credential:
Phone: 719-572-6197