Organization
ADULT/YOUTH COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROY MCCLENDON MA, CDACIII, MAC (DIRECTOR)
(719) 442-1779
Entity
Organization
Contact information
Practice address
223 N WAHSATCH AVE, SUITE 101, COLORADO SPRINGS, CO 80903-3479
(719) 442-1779
(719) 442-0538
Mailing address
223 N WAHSATCH AVE, SUITE 101, COLORADO SPRINGS, CO 80903-3479
(719) 442-1779
(719) 442-0538
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
12880
CO
Other
Enumeration date
06/02/2009
Last updated
06/02/2009
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