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Organization

SPECIAL KIDS SPECIAL FAMILIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LINDA K ELLEGARD LPC (EXECUTIVE DIRECTOR)
(719) 447-8983
Entity
Organization

Contact information

Practice address
424 W PIKES PEAK AVE, COLORADO SPRINGS, CO 80905-1525
(719) 447-8983
(719) 447-9482
Mailing address
3830 STETSON CT, COLORADO SPRINGS, CO 80907-4906
(720) 988-9511
(719) 345-1820

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1629515507
CO
05
92608264
CO
Enumeration date
06/28/2018
Last updated
06/28/2018
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