Organization
RURAL ANGELS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALEXANDRIA A BROCKMAN (OWNER/PROVIDER)
(307) 287-5377
Entity
Organization
Contact information
Practice address
1484 MORNINGVIEW LN, CASTLE ROCK, CO 80109-3740
(307) 287-5377
Mailing address
1484 MORNINGVIEW LN, CASTLE ROCK, CO 80109-3740
(307) 287-5377
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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