HAVEN BEHAVIORAL SERVICES OF PUEBLO, LLC (NPI# 1013312107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013312107 |
| Entity Type | Organization |
| Organization Name | HAVEN BEHAVIORAL SERVICES OF PUEBLO, LLC |
| Other Organization Name | HAVEN WARRIOR SUPPORT CENTER |
| Practice Address |
1330 Quail Lake Loop Suite 240 Colorado Springs CO 80906-4651 |
| Mailing Address |
3102 West End Avenue Suite 1000 Nashville TN 37203-1324 |
| Practice Telephone | 7196405445 |
| Practice Fax Number | 7193551789 |
| Mailing Telephone | 6153938800 |
| Mailing Fax Number | 6153938844 |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2014-10-31 |
| Authorized Official Name | MS. CHRISTY KELTNER (AVP REVENUE CYCLE) |
| Authorized Official Telephone | 6153938816 |
| Is Organization Subpart | Y |
| Parent Organization Name | HAVEN BEHAVIORAL HEALTHCARE INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Haven Warrior Support Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487868170 | Haven Behavioral Services of Pueblo, LLC | Psychiatric Hospital | 1008 Minnequa Ave, Suite 6100, Pueblo, CO 81004-3733 | 2007-05-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Haven Behavioral Services of Pueblo, LLC | 3102 West End Avenue, Suite 1000, Nashville, TN 37203 |
| Street Address |
1330 QUAIL LAKE LOOP SUITE 240 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80906-4651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386626984 | Jeannine Beaumont Laforce | Physical Therapist | 1330 Quail Lake Loop, Suite 100 Pt Works Cheyenne Mountain Clinic, Colorado Springs, CO 80906-4651 | 2005-11-18 |
| 1073124277 | Chandler Alexander Collins | Physical Therapist | 1330 Quail Lake Loop, Suite 100, Colorado Springs, CO 80906 | 2020-08-11 |
| 1992345565 | Eric Moore | Nurse Practitioner | 1330 Quail Lake Loop, Colorado Springs, CO 80906-4651 | 2020-01-13 |
| 1487111696 | Samatha E Demott | Occupational Therapist | 1330 Quail Lake Loop, Colorado Springs, CO 80906-4651 | 2019-02-23 |
| 1972097715 | Melonie Purcell | Behavior Technician | 1330 Quail Lake Loop, Colorado Springs, CO 80906-4651 | 2018-06-15 |
| 1396239141 | Alexis Budzeak | Behavior Technician | 1330 Quail Lake Loop, Colorado Springs, CO 80906-4651 | 2018-06-15 |
| 1033625421 | Alyssa Harms | Behavior Technician | 1330 Quail Lake Loop, Colorado Springs, CO 80906-4651 | 2017-12-20 |
| 1174039630 | Elaine Butterfield | Behavior Technician | 1330 Quail Lake Loop, Suite 200, Colorado Springs, CO 80906 | 2017-12-20 |
| 1023524584 | Courtney Gillis | Behavior Technician | 1330 Quail Lake Loop, Colorado Springs, CO 80906-4651 | 2017-12-20 |
| 1558877035 | Merry Hammack | Behavior Technician | 1330 Quail Lake Loop, Colorado Springs, CO 80906-4651 | 2017-12-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437797339 | Michael Crise | Behavior Technician | 1330 Qual Lake Loop Ste 120, Colorado Springs, CO 80906 | 2019-12-11 |
| 1730720541 | Amanda Salinas | Massage Therapist | 1235 Lake Plaza Drive Suite 230, Colorado Springs, CO 80906 | 2019-10-02 |
| 1225511488 | Sheila Meggison | Massage Therapist | 1235 Lake Plaza Drive, Suite 230, Colorado Springs, CA 80906 | 2018-09-12 |
| 1316429756 | Vivus Counseling Services LLC | Counselor | 108 East Cheyenne Rd Suite 201, Colorado Springs, CO 80906 | 2018-09-01 |
| 1043796949 | Erin Lee Recinos | Nurse Practitioner | 225 E Cheyenne Mountain Blvd Ste 220, Colorado Springs, CO 80906 | 2018-07-13 |
| 1982103875 | Savannah Adeline Rentrop | Behavior Technician | 2989 Broadmoor Valley Rd D, Colorado Springs, CO 80906 | 2018-02-06 |
| 1205335288 | Ross Knowlton | Behavior Technician | 1330 Quail Lake Loop Suite 200, Colorado Springs, CO 80906 | 2018-02-06 |
| 1942709845 | Adrienne Bohlen | Behavior Technician | 1330 Quail Lake Loop, Ste. 200, Colorado Springs, CO 80906 | 2018-02-06 |
| 1881110088 | Christine Gonzales | Nurse Practitioner | 2739 E Las Vegas St, Colorado Springs, CO 80906 | 2017-08-18 |
| 1225568470 | Larry Alwine | Counselor | 2860 South Circle Drive, Unit 250k, Colorado Springs, CO 80906 | 2017-06-19 |
| Find all providers in zip 80906 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033736699 | A Phoenix Rising, LLC | Clinic/Center | 731 N Weber St Ste 211, Colorado Springs, CO 80903-1019 | 2020-06-30 |
| 1366959769 | Behavioral Health Consultants, Inc. | Clinic/Center | 3210 North Academy Blvd, Suite 3, Colorado Springs, CO 80917 | 2018-01-08 |
| 1306170964 | Henderson Consulting & Eap Services | Clinic/Center | 7750 N. Union Blvd., Suite 102, Colorado Springs, CO 80920-4081 | 2009-09-29 |
| 1194331215 | Tracie A Nicoll Phd | Clinic/Center | 245 E Cheyenne Mountain Blvd, Colorado Springs, CO 80906-3719 | 2020-09-23 |
| 1316560345 | Meliora Therapy and Consulting LLC | Clinic/Center | 3230 E Woodmen Rd Ste 110a, Colorado Springs, CO 80920-8502 | 2020-05-26 |
| 1922653963 | Harmon Counseling, LLC | Clinic/Center | 5555 Erindale Dr Ste 203, Colorado Springs, CO 80918-6965 | 2019-08-06 |
| 1003377128 | Lentz Psychological Services, Inc | Clinic/Center | 5526 N Academy Blvd Ste 110, Colorado Springs, CO 80918-3688 | 2019-03-29 |
| 1528549375 | Front Range Psychology Services, LLC | Clinic/Center | 1843 Austin Bluffs Pkwy, Colorado Springs, CO 80918-7857 | 2018-08-28 |
| 1609390053 | August Advice | Clinic/Center | 3709 Parkmoor Village Dr, Colorado Springs, CO 80917-6252 | 2017-07-27 |
| 1922493584 | Jennifer L. Beyer, Lcsw, Inc | Clinic/Center | 723 N Nevada Ave, Colorado Springs, CO 80903-1007 | 2015-03-31 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80906 |
Please comment or provide details below to improve the information on HAVEN BEHAVIORAL SERVICES OF PUEBLO, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.