Provider Demographics
NPI:1548430812
Name:KIDS RESOURCE NETWORK OF COLORADO SPRINGS
Entity Type:Organization
Organization Name:KIDS RESOURCE NETWORK OF COLORADO SPRINGS
Other - Org Name:FAMILY RESOURCE NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAWNTEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-227-7477
Mailing Address - Street 1:5360 N ACADEMY BLVD
Mailing Address - Street 2:130
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4006
Mailing Address - Country:US
Mailing Address - Phone:719-227-7477
Mailing Address - Fax:719-227-7474
Practice Address - Street 1:5360 N ACADEMY BLVD
Practice Address - Street 2:130
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4006
Practice Address - Country:US
Practice Address - Phone:719-227-7477
Practice Address - Fax:719-227-7474
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIDS RESOURCE NETWORK OF COLORADO SPRINGS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-03
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1508602251B00000X, 251K00000X, 251S00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No252Y00000XAgenciesEarly Intervention Provider Agency