MEDICARE: PEAK SUPPORTIVE SERVICES

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	385H00000X	Respite Care

General Provider Information

NPI Number	:	1578252599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK SUPPORTIVE SERVICES

Provider Business Mailing Address
First Line	:	2420 E WILLAMETTE AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-4841
Country	:	US
Telephone Number	:	719-576-2900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2420 E WILLAMETTE AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-4841
Country	:	US
Telephone Number	:	719-576-2900
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BREGITTA HUGHES
Credential	:
Telephone Number	:	719-576-2900

Provider Enumeration Date	:	05/04/2023
Last Update Date	:	05/04/2023

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Directions to “PEAK SUPPORTIVE SERVICES ” Practice Location

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