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NPI Code Detail

MEDICARE: SPRINGBOK HEALTH INC

MEDICARE: SPRINGBOK HEALTH INC
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
1101YM0800XMental Health CounselorAPN.0990467-NPCO
2363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1952781601
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPRINGBOK HEALTH INC
Provider Business Mailing Address
First Line : 1318 W COLORADO AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-4023
Country : US
Telephone Number : 719-766-8511
Fax Number : 719-208-7731
Provider Business Practice Location Address
First Line : 1923 W COLORADO AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-3838
Country : US
Telephone Number : 719-766-8511
Fax Number : 719-208-7731
Authorized Official
Title or Position : OWNER
Name : MR. MARK JANKELOW
Credential : PMHNP-BC
Telephone Number : 719-251-6877
Provider Enumeration Date : 06/08/2015
Last Update Date : 06/09/2025

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