Organization
MGA BEHAVIOR THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN GRANT (VICE PRESIDENT)
(719) 212-6535
Entity
Organization
Contact information
Practice address
1355 GARDEN OF THE GODS RD STE 150, COLORADO SPRINGS, CO 80907-3595
(719) 212-6535
(719) 212-6539
Mailing address
1355 GARDEN OF THE GODS RD STE 150, COLORADO SPRINGS, CO 80907-3595
(719) 212-6535
(719) 212-6539
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/15/2021
Last updated
07/11/2023
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