Organization
CHILD COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE PETERSON (EXECUTIVE DIRECTOR/CEO)
(719) 424-3839
Entity
Organization
Contact information
Practice address
2175 ACADEMY CIR STE 1, COLORADO SPRINGS, CO 80909-1695
(719) 440-6445
Mailing address
2175 ACADEMY CIR STE 1, COLORADO SPRINGS, CO 80909-1695
(719) 440-6445
(719) 424-3839
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000163300
—
CO
Enumeration date
10/09/2018
Last updated
10/09/2018
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