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General NPI Number Information
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NPI Number | 1053933135
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Entity Type | Organization
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Legal Business Name | SANDSTONE CARE COS, LLC
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Dates
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Enumeration Date | 05/12/2020
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | 5731 N ACADEMY BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-3684
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Country | US
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Telephone | 719-445-3260
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Fax |
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Provider Business Mailing Address
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Address Line | 7555 E HAMPDEN AVE STE 103
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City | DENVER
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State | CO
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Zip | 80231-4832
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Country | US
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Telephone | 720-372-1490
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARCELLO LA ROCCA
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Credential |
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Telephone | 720-372-1490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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