Healthcare Provider Details

I. General information

NPI: 1770707739
Provider Name (Legal Business Name): CEDAR SPRINGS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 12/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2135 SOUTHGATE RD
COLORADO SPRINGS CO
80906-2605
US

IV. Provider business mailing address

2135 SOUTHGATE RD
COLORADO SPRINGS CO
80906-2605
US

V. Phone/Fax

Practice location:
  • Phone: 719-329-5353
  • Fax:
Mailing address:
  • Phone: 719-633-4114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number3160
License Number StateCO

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: SRVP CFO
Credential:
Phone: 610-768-3300