Provider Demographics
NPI:1689206401
Name:ROCKY MOUNTAIN KIDS
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FELICE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIQUORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-330-7244
Mailing Address - Street 1:2210 E LASALLE ST #101
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909
Mailing Address - Country:US
Mailing Address - Phone:719-330-7244
Mailing Address - Fax:719-635-3601
Practice Address - Street 1:2129 N NEVADA AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6916
Practice Address - Country:US
Practice Address - Phone:719-330-7244
Practice Address - Fax:719-635-3601
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROCKY MOUNTAIN KIDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children