Organization
ROCKY MOUNTAIN BEHAVIORAL HEALTH, INC.
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
3239 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(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
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
302F00000X
Exclusive Provider Organization
1063-00
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28377834
—
CO
Enumeration date
03/24/2006
Last updated
11/21/2025
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