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Organization
ITZA CORAZON COMMUNITY SERVICES LLC
Active
Organization
ITZA CORAZON COMMUNITY SERVICES LLC
Active
Other names
ITZA Corazon Community Services LL, ITZA Corazon Community Services
Organization subpart
No
Provider details
NPI number
Authorized official
PEDRO F RIDDELL LSW, LACC (CEO)
(530) 786-9882
Entity
Organization
Contact information
Practice address
518 N CHELTON RD STE 210, COLORADO SPRINGS, CO 80909-5256
(710) 500-6009
Mailing address
1160 LAKE PLAZA DR STE 200, COLORADO SPRINGS, CO 80906-3507
(719) 500-6009
(719) 890-7162
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
251K00000X
Public Health or Welfare Agency
—
—
261Q00000X
Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/10/2024
Last updated
05/06/2026
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