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General NPI Number Information
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NPI Number | 1578302980
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Entity Type | Organization
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Legal Business Name | COMMON GROUND SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 05/23/2024
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 3535 PARKMOOR VILLAGE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80917-5292
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Country | US
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Telephone | 719-232-3498
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Fax |
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Provider Business Mailing Address
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Address Line | 3535 PARKMOOR VILLAGE DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80917-5292
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Country | US
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Telephone | 719-232-3498
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Fax |
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Authorized Official
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Title or Position | BCBA
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Name | SHERI NIVEN
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Credential |
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Telephone | 719-232-3498
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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 | 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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