Organization
HOMEWARD PIKES PEAK
Active
Other names
Harbor House Clinical Servcies
Organization subpart
No
Provider details
NPI number
Authorized official
LYNNETTE CARMICHAEL (CLINICAL ADMIN)
(719) 473-5557
Entity
Organization
Contact information
Practice address
2010 E BIJOU ST, COLORADO SPRINGS, CO 80909-5819
(719) 473-5557
(719) 473-6442
Mailing address
2010 E BIJOU ST, COLORADO SPRINGS, CO 80909-5819
(719) 473-5557
(719) 473-6442
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
161401
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161401
OLD LICENSE NUMBER
CO
05
—
42125251
—
CO
Enumeration date
01/15/2013
Last updated
07/08/2021
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