Healthcare Provider Details

I. General information

NPI: 1336729821
Provider Name (Legal Business Name): ROCKY HEIGHTS WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 02/28/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10841 CROSSROADS DR STE 112
PARKER CO
80134-9089
US

IV. Provider business mailing address

5325 NW 118TH AVE
CORAL SPRINGS FL
33076-3228
US

V. Phone/Fax

Practice location:
  • Phone: 720-545-5722
  • Fax:
Mailing address:
  • Phone: 303-868-3134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRIANA HAIGHT
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 720-545-5722