Healthcare Provider Details

I. General information

NPI: 1417565326
Provider Name (Legal Business Name): ROUNDUP FELLOWSHIP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2020
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5045 LIST DR
COLORADO SPRINGS CO
80919-3321
US

IV. Provider business mailing address

3443 S GALENA ST STE 310
DENVER CO
80231-5079
US

V. Phone/Fax

Practice location:
  • Phone: 719-666-7836
  • Fax:
Mailing address:
  • Phone: 303-970-9094
  • Fax: 303-353-8305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: ANDREA RYBUS
Title or Position: ACCOUNTING MANAGER
Credential:
Phone: 303-970-9094