Organization
ITZA CORAZON COMMUNITY SERVICES LLC
Active
Other names
ITZA Corazon Community Services LL, ITZA Corazon Community Services
Organization subpart
No
Provider details
NPI number
Authorized official
PEDRO F RIDDELL LSW, LACC (CEO)
(530) 786-9882
Entity
Organization
Contact information
Practice address
518 N CHELTON RD STE 210, COLORADO SPRINGS, CO 80909-5256
(710) 500-6009
Mailing address
1160 LAKE PLAZA DR STE 200, COLORADO SPRINGS, CO 80906-3507
(719) 500-6009
(719) 890-7162
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
251K00000X
Public Health or Welfare Agency
—
—
261Q00000X
Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/10/2024
Last updated
05/06/2026
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