| Rocky Mountain Behavioral Health, Inc. | |
|
3239 Independence Rd Canon City CO 81212-9380 | |
| (719) 275-7650 | |
| (719) 275-4209 |
| Full Name | Rocky Mountain Behavioral Health, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3239 Independence Rd, Canon City, Colorado |
| Authorized Official Name and Position | Lois R Petersen-kelley (BUSINESS MANAGER) |
| Authorized Official Contact | 7192757650 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rocky Mountain Behavioral Health, Inc. 3239 Independence Rd Canon City CO 81212-9380 Ph: (719) 275-7650 | Rocky Mountain Behavioral Health, Inc. 3239 Independence Rd Canon City CO 81212-9380 Ph: (719) 275-7650 |
| NPI Number | 1922068931 |
|---|---|
| Provider Enumeration Date | 03/24/2006 |
| Last Update Date | 06/07/2022 |
| Certification Date | 06/07/2022 |
| Medicare PECOS PAC ID | 7719304443 |
|---|---|
| Medicare Enrollment ID | O20200826003104 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922068931 | NPI | - | NPPES |
| 28377834 | Medicaid | CO |
| Provider Name | Javier D Castillo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801985924 PECOS PAC ID: 5193142826 Enrollment ID: I20200826003058 |
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