Provider Demographics
NPI:1497355382
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:EVERY CHILD PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATIVE OPERATIO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
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 1:1630 S ACOMA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-3602
Practice Address - Country:US
Practice Address - Phone:303-450-3690
Practice Address - Fax:303-962-1511
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROCKY MOUNTAIN YOUTH MEDICAL AND NURSING CONSULTANTS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-29
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO98503723Medicaid