Organization
ROCKY MOUNTAIN BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOIS R PETERSEN-KELLEY (BUSINESS MANAGER)
(719) 275-7650
Entity
Organization
Contact information
Practice address
685 CITADEL DR E STE 125, COLORADO SPRINGS, CO 80909-5316
(719) 275-7650
(719) 275-4209
Mailing address
3239 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(719) 275-7650
(719) 275-4209
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
302F00000X
Exclusive Provider Organization
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063-03
—
CO
Enumeration date
10/28/2020
Last updated
06/07/2022
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