Provider Demographics
NPI:1851080089
Name:RED ROCKS PSYCHIATRY
Entity Type:Organization
Organization Name:RED ROCKS PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PINO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:720-710-7332
Mailing Address - Street 1:7114 W JEFFERSON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80235-2356
Mailing Address - Country:US
Mailing Address - Phone:720-710-7332
Mailing Address - Fax:720-306-5332
Practice Address - Street 1:7114 W JEFFERSON AVE STE 200
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2356
Practice Address - Country:US
Practice Address - Phone:720-710-7332
Practice Address - Fax:720-306-5332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty