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Organization

SPECIAL KIDS SPECIAL FAMILIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LINDA K ELLEGARD LPC (EXECUTIVE DIRECTOR AND CLINICIAN)
(719) 447-8983
Entity
Organization

Contact information

Practice address
424 W PIKES PEAK AVE, COLORADO SPRINGS, CO 80905-1525
(719) 447-8983
(719) 447-9482
Mailing address
3830 STETSON CT, COLORADO SPRINGS, CO 80907-4906
(720) 988-9511
(719) 345-1780

Taxonomy

Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
CO
385HR2055X
Child Mental Illness Respite Care
43184
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
43184
FOSTER CARE LICENSE
CO
05
92608264
CO
Enumeration date
06/28/2018
Last updated
06/28/2018
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