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General NPI Number Information
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NPI Number | 1548623226
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Entity Type | Organization
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Legal Business Name | FAMILY ROCS
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Dates
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Enumeration Date | 03/31/2016
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Last Update Date | 03/31/2016
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Provider Practice Location Address
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Address Line | 108 E CHEYENNE RD STE 200
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-2504
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Country | US
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Telephone | 719-205-1977
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Fax |
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Provider Business Mailing Address
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Address Line | 108 E CHEYENNE RD STE 200
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-2504
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Country | US
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Telephone | 719-205-1977
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AFRAH CARABALLO
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Credential | LCSW
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Telephone | 719-205-1977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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