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General NPI Number Information
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NPI Number | 1801471982
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Entity Type | Organization
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Legal Business Name | SPRINGS BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 1465 KELLY JOHNSON BLVD STE 305
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3947
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Country | US
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Telephone | 719-495-3359
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Fax | 719-691-7003
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Provider Business Mailing Address
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Address Line | 1465 KELLY JOHNSON BLVD STE 305
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3947
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Country | US
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Telephone | 719-495-3359
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Fax | 719-691-7003
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Authorized Official
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Title or Position | CEO
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Name | DR. OMAR AHMED KHAN
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Credential | DNP
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Telephone | 719-495-3359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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