Provider Demographics
NPI:1871831800
Name:THERAPIES OF THE ROCKIES
Entity Type:Organization
Organization Name:THERAPIES OF THE ROCKIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-888-4840
Mailing Address - Street 1:685 CITADEL DR E
Mailing Address - Street 2:250
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5314
Mailing Address - Country:US
Mailing Address - Phone:303-888-4840
Mailing Address - Fax:303-362-8986
Practice Address - Street 1:685 CITADEL DR E
Practice Address - Street 2:250
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5314
Practice Address - Country:US
Practice Address - Phone:303-888-4840
Practice Address - Fax:303-362-8986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12102075235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO67777066Medicaid