Organization
BRAD'S HOUSE MESA RIDGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK HAGGARD (BILLING MANAGER)
(719) 641-6051
Entity
Organization
Contact information
Practice address
646 DEXTER ST, COLORADO SPRINGS, CO 80911-2542
(719) 204-4548
Mailing address
14960 WOODCARVER RD, COLORADO SPRINGS, CO 80921-2370
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/20/2024
Last updated
04/25/2025
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