Provider Demographics
NPI:1316540750
Name:ROCKY MOUNTAIN YOUTH MEDICAL AND NURSING CONSULTANTS, INC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN YOUTH MEDICAL AND NURSING CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAFOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-450-3690
Mailing Address - Street 1:9197 GRANT ST STE 100
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4331
Mailing Address - Country:US
Mailing Address - Phone:303-450-3690
Mailing Address - Fax:
Practice Address - Street 1:11700 E 11TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-3758
Practice Address - Country:US
Practice Address - Phone:303-326-1570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROCKY MOUNTAIN YOUTH MEDICAL AND NURSING CONSULTANTS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000153317Medicaid