Healthcare Provider Details

I. General information

NPI: 1386554863
Provider Name (Legal Business Name): LOYALS-SUPPORT-SERVICES-LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 DEL MAR DR
COLORADO SPRINGS CO
80910-1538
US

IV. Provider business mailing address

8080 RASPBERRY DR
FREDERICK CO
80504-6767
US

V. Phone/Fax

Practice location:
  • Phone: 303-862-2977
  • Fax:
Mailing address:
  • Phone: 303-862-2977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALFRED MONTANO
Title or Position: OWNER
Credential:
Phone: 303-862-2977