Healthcare Provider Details

I. General information

NPI: 1275373821
Provider Name (Legal Business Name): TEEN CHALLENGE OF THE ROCKY MOUNTAINS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7750 6025 RD
OLATHE CO
81425-9407
US

IV. Provider business mailing address

PO BOX 336
ENGLEWOOD CO
80151-0336
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DAVID SELLAR
Title or Position: CLINICAL DIRECTOR
Credential: MA, LPC, LAC
Phone: 720-389-9142