MEDICARE: COMMUNITY ANCHOR ACADEMY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor
3	171M00000X	Case Manager/Care Coordinator
4	175T00000X	Peer Specialist
5	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1093675068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY ANCHOR ACADEMY

Provider Business Mailing Address
First Line	:	5820 FOSSIL DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-7688
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1652 S CIRCLE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-4433
Country	:	US
Telephone Number	:	719-203-4758
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JUAQUIN MOBLEY
Credential	:
Telephone Number	:	720-339-5830

Provider Enumeration Date	:	11/13/2025
Last Update Date	:	11/13/2025

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