Healthcare Provider Details

I. General information

NPI: 1225636673
Provider Name (Legal Business Name): ROCKY MOUNTAIN YOUTH MEDICAL AND NURSING CONSULTANTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2020
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N DOLORES RD
CORTEZ CO
81321-4213
US

IV. Provider business mailing address

9197 GRANT ST STE 100
THORNTON CO
80229-4331
US

V. Phone/Fax

Practice location:
  • Phone: 970-565-1150
  • Fax:
Mailing address:
  • Phone: 303-450-3690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAUL BROWN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 303-450-3690