Organization
COLORADO'S CHILDHOOD CANCER AND DISABILITIES CAMPS, INC.
Active
Other names
Colorado Mountain Recovery at Lost Creek Ranch
Organization subpart
No
Provider details
NPI number
Authorized official
CHEYENNE TAYLOR GARRISON (DRUG AND ALCOHOL PROGRAM MANAGER)
(719) 493-0937
Entity
Organization
Contact information
Practice address
51934 SOUTH HIGHWAY 285, GRANT, CO 80448-8042
(719) 963-7528
Mailing address
530 COMMUNICATION CIR, COLORADO SPRINGS, CO 80905-1744
(719) 493-0937
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
—
—
133N00000X
Nutritionist
—
—
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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