Healthcare Provider Details

I. General information

NPI: 1194483586
Provider Name (Legal Business Name): TEEN CHALLENGE OF THE ROCKY MOUNTAINS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2021
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 S BANNOCK ST STE 1020
ENGLEWOOD CO
80110-2512
US

IV. Provider business mailing address

PO BOX 336
ENGLEWOOD CO
80151-0336
US

V. Phone/Fax

Practice location:
  • Phone: 303-744-3986
  • Fax:
Mailing address:
  • Phone: 720-389-9142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID SELLAR
Title or Position: CLINICAL DIR/COUNSELING SUP
Credential: LPC, LAC
Phone: 720-389-9142