Provider Demographics
NPI:1811201569
Name:REBUILDING TOGETHER COLORADO SPRINGS
Entity Type:Organization
Organization Name:REBUILDING TOGETHER COLORADO SPRINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURIAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MIZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-634-4115
Mailing Address - Street 1:1975 RESEARCH PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-1025
Mailing Address - Country:US
Mailing Address - Phone:719-634-4115
Mailing Address - Fax:888-315-6936
Practice Address - Street 1:1975 RESEARCH PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1025
Practice Address - Country:US
Practice Address - Phone:719-634-4115
Practice Address - Fax:888-315-6936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies