Organization
BRAD'S HOUSE PUEBLO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK HAGGARD (BILLING DIRECTOR)
(719) 308-1213
Entity
Organization
Contact information
Practice address
422 BROADWAY AVE, PUEBLO, CO 81004-2128
(719) 308-1213
Mailing address
14960 WOODCARVER RD # 201, COLORADO SPRINGS, CO 80921-2370
(719) 308-1213
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
04/29/2025
Last updated
04/29/2025
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