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General NPI Number Information
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NPI Number | 1154205516
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Entity Type | Organization
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Legal Business Name | WILD SUN BEHAVIORAL SERVICES, LLC
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 685 BRIGGS ST
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City | ERIE
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State | CO
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Zip | 80516-5022
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Country | US
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Telephone | 720-849-2668
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Fax | 720-787-4192
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Provider Business Mailing Address
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Address Line | 1151 S DAVENPORT CT
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City | ERIE
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State | CO
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Zip | 80516-6937
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Country | US
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Telephone | 720-849-2668
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Fax | 720-787-4192
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Authorized Official
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Title or Position | OWNER/EXECUTIVE DIRECTOR
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Name | DANIEL KURTY
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Credential | BCBA
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Telephone | 720-849-2668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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