Healthcare Provider Details

I. General information

NPI: 1205730355
Provider Name (Legal Business Name): MRS. KARLITA ANTOUIA MAES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7239 DUTCH LOOP
COLORADO SPRINGS CO
80925-9473
US

IV. Provider business mailing address

1313 E LAS ANIMAS ST
COLORADO SPRINGS CO
80910-3615
US

V. Phone/Fax

Practice location:
  • Phone: 719-653-4175
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: