Healthcare Provider Details

I. General information

NPI: 1750210332
Provider Name (Legal Business Name): ROCKY MOUNTAIN RECOVERY CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1929 E EVANS AVE
PUEBLO CO
81004-3526
US

IV. Provider business mailing address

2420 E MONUMENT ST UNIT A
COLORADO SPRINGS CO
80909-4870
US

V. Phone/Fax

Practice location:
  • Phone: 719-407-7622
  • Fax:
Mailing address:
  • Phone: 719-407-1211
  • Fax: 719-407-1211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK ELTON SMITH
Title or Position: OWNER/DIRECTOR OF OPERATIONS
Credential: SMITH
Phone: 719-407-1211