Healthcare Provider Details

I. General information

NPI: 1912817230
Provider Name (Legal Business Name): RAUL CRUZ-TORRES RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 SANTA FE AVE
FOUNTAIN CO
80817
US

IV. Provider business mailing address

319 E BROOKSIDE ST APT 13
COLORADO SPRINGS CO
80905-7453
US

V. Phone/Fax

Practice location:
  • Phone: 719-822-0550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: