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General NPI Number Information
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NPI Number | 1700791233
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Entity Type | Organization
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Legal Business Name | ROCKY MOUNTAIN RECOVERY HOMES INC
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Dates
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Enumeration Date | 08/18/2026
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Last Update Date | 08/18/2026
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Provider Practice Location Address
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Address Line | 4620 EDISON AVE STE J
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City | COLORADO SPRINGS
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State | CO
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Zip | 80915-4198
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Country | US
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Telephone | 970-445-0515
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Fax |
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Provider Business Mailing Address
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Address Line | 4620 EDISON AVE STE J
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City | COLORADO SPRINGS
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State | CO
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Zip | 80915-4198
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Country | US
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Telephone | 970-445-0515
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARCUS BLACKSTOCK
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Credential |
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Telephone | 970-445-0514
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care 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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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