Organization
LARRY E. SHORES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABBY WHITESIDE (BILLING AGENT)
(719) 749-0256
Entity
Organization
Contact information
Practice address
2135 SOUTHGATE RD, COLORADO SPRINGS, CO 80906-2605
(719) 633-4114
(719) 633-5987
Mailing address
2135 SOUTHGATE RD, COLORADO SPRINGS, CO 80906-2605
(719) 633-4114
(719) 633-5987
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
34757
CO
Other
Enumeration date
02/10/2012
Last updated
04/19/2012
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