Provider Demographics
NPI:1891498556
Name:ALL TERRAIN BEHAVIOR HEALTH GROUP
Entity Type:Organization
Organization Name:ALL TERRAIN BEHAVIOR HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:719-229-8879
Mailing Address - Street 1:6805 CORPORATE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1977
Mailing Address - Country:US
Mailing Address - Phone:719-726-8811
Mailing Address - Fax:
Practice Address - Street 1:212 W 13TH ST STE 201
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3754
Practice Address - Country:US
Practice Address - Phone:719-726-8811
Practice Address - Fax:719-631-0699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)