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General NPI Number Information
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NPI Number | 1093477473
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Entity Type | Organization
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Legal Business Name | RED ROCK CHILD AND FAMILY SERVICES LLC
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Dates
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Enumeration Date | 10/12/2021
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 225 E CHEYENNE MOUNTAIN BLVD STE 140
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-3700
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Country | US
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Telephone | 713-894-5571
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Fax | 713-490-3167
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Provider Business Mailing Address
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Address Line | 225 E CHEYENNE MOUNTAIN BLVD STE 140
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-3700
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Country | US
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Telephone | 713-894-5571
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Fax | 713-490-3167
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Authorized Official
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Title or Position | MR
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Name | WADE KING
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Credential | LPC
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Telephone | 713-894-5571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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