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General NPI Number Information
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NPI Number | 1285139220
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Entity Type | Organization
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Legal Business Name | FAMILY CONNECT INC.
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 3709 PARKMOOR VILLAGE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80917-6252
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Country | US
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Telephone | 719-600-8049
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Fax |
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Provider Business Mailing Address
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Address Line | 3709 PARKMOOR VILLAGE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80917-6252
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Country | US
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Telephone | 719-600-8049
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LAURA OLSON
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Credential | MS, MED
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Telephone | 719-600-8049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty 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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