MEDICARE: TRANSITIONAL RECOVERY NETWORK

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1497611453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSITIONAL RECOVERY NETWORK

Provider Business Mailing Address
First Line	:	3622 GALLEY RD # 201
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-4316
Country	:	US
Telephone Number	:	719-755-1822
Fax Number	:

Provider Business Practice Location Address
First Line	:	3622 GALLEY RD # 201
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-4316
Country	:	US
Telephone Number	:	719-755-1822
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	RYAN COLE
Credential	:	PSY.D
Telephone Number	:	719-755-1822

Provider Enumeration Date	:	01/02/2026
Last Update Date	:	01/02/2026

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