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General NPI Number Information
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NPI Number | 1699655373
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Entity Type | Organization
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Legal Business Name | PURPLE MOUNTAIN RECOVERY INC
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 3225 AUSTIN BLUFFS PKWY STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-5768
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Country | US
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Telephone | 719-445-0621
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Fax |
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Provider Business Mailing Address
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Address Line | 3225 AUSTIN BLUFFS PKWY STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-5768
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Country | US
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Telephone | 719-445-0621
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SCOTT JAY MOSHER-RAMIREZ
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Credential |
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Telephone | 719-407-4876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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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 | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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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 | 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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