Provider Demographics
NPI:1508381203
Name:KAIROS FAMILY SERVICES, LLC
Entity Type:Organization
Organization Name:KAIROS FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:PURYEAR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:719-238-7908
Mailing Address - Street 1:13170 CRANE CANYON LOOP
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-7222
Mailing Address - Country:US
Mailing Address - Phone:719-238-7908
Mailing Address - Fax:
Practice Address - Street 1:7660 GODDARD ST STE 258
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-8237
Practice Address - Country:US
Practice Address - Phone:209-304-3444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-03
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty