Provider Demographics
NPI:1003163429
Name:PEAK INTERVENTIONS LLC
Entity Type:Organization
Organization Name:PEAK INTERVENTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:ENOS
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, BCBA
Authorized Official - Phone:720-384-5312
Mailing Address - Street 1:1118 N ARCADIA ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2639
Mailing Address - Country:US
Mailing Address - Phone:720-384-5312
Mailing Address - Fax:
Practice Address - Street 1:1118 N ARCADIA ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2639
Practice Address - Country:US
Practice Address - Phone:720-384-5312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-11-8937103K00000X
CO37593103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty