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General NPI Number Information
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NPI Number | 1235542994
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Entity Type | Organization
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Legal Business Name | ROCKY MOUNTAIN HEALTH CARE SERVICES
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Dates
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Enumeration Date | 06/10/2014
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 2812 E BIJOU ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-6339
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Country | US
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Telephone | 719-213-2337
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Fax |
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Provider Business Mailing Address
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Address Line | 2812 E BIJOU ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-6339
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Country | US
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Telephone | 719-213-2337
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF DEVELOPMENT
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Name | BRENDA HEIMBACK
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Credential | LPC
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Telephone | 719-466-8777
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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 | 7454
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License Number State | CO
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