# ROCKY MOUNTAIN TRANSFORMATIONAL RECOVERY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891520060
- **Authorized official:** MIKE MATTICE (OWNER)
- **Authorized official phone:** (719) 505-3467

## Contact information

- **Practice address:** 1716 E YAMPA ST, COLORADO SPRINGS, CO 80909-3855
- **Practice address phone:** (719) 505-3467
- **Mailing address:** 1716 E YAMPA ST, COLORADO SPRINGS, CO 80909-3855

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/05/2024
- **Last updated:** 09/05/2024