Organization
PEAK VISTA COMMUNITY HEALTH CENTERS
Active
Parent organization
PEAK VISTA COMMUNITY HEALTH CENTERS
Other names
Enrichment and Counseling Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEAK VISTA COMMUNITY HEALTH CENTERS
Authorized official
RYAN SPILLANE (INTERIM CHIEF FINANCIAL OFFICER)
(719) 344-7135
Entity
Organization
Contact information
Practice address
3207 N ACADEMY BLVD STE 100, COLORADO SPRINGS, CO 80917-5117
(719) 632-5700
Mailing address
3205 N ACADEMY BLVD STE 130, COLORADO SPRINGS, CO 80917-5152
(719) 632-5700
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05638267
—
CO
05
—
9000186598
—
CO
Enumeration date
07/17/2020
Last updated
01/30/2023
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