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Organization
SOARING EAGLES CENTER FOR AUTISM
Active
Organization
SOARING EAGLES CENTER FOR AUTISM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAREN W. COLVIN M.D. (EXECUTIVE DIRECTOR)
(719) 547-8803
Entity
Organization
Contact information
Practice address
125 W PALMER LAKE DR, PUEBLO WEST, CO 81007-2876
(719) 547-8803
(719) 547-8806
Mailing address
PO BOX 7878, PUEBLO WEST, CO 81007-0878
(719) 547-8803
(719) 547-8806
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
34666
CO
103K00000X
Behavior Analyst
Primary
1-17-30000
CO
251S00000X
Community/Behavioral Health Agency
34666
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80986226
—
CO
Enumeration date
02/21/2008
Last updated
03/26/2018
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