HAVEN BEHAVIORAL OUTPATIENT SERVICES OF COLORADO, LLC (NPI# 1396380994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396380994 |
| Entity Type | Organization |
| Organization Name | HAVEN BEHAVIORAL OUTPATIENT SERVICES OF COLORADO, LLC |
| Practice Address |
1026 W Abriendo Ave Pueblo CO 81004-1128 |
| Mailing Address |
1330 Quail Lake Loop Ste 200 Colorado Springs CO 80906-4651 |
| Practice Telephone | 7192523327 |
| Practice Fax Number | 7195454905 |
| Mailing Telephone | 7195402152 |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2019-11-07 |
| Authorized Official Name | SHERIE TERRANOVA (OPERATIONS DIRECTOR) |
| Authorized Official Telephone | 7195402152 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Family Support Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198067 | Haven Behavioral Outpatient Services of Colorado, LLC | Clinic/Center | 155 Printers Pkwy Ste 120, Colorado Springs, CO 80910-6101 | 2019-11-07 |
| 1164067765 | Haven Behavioral Outpatient Services of Colorado, LLC | Clinic/Center | 6160 Tutt Blvd Ste 120, Colorado Springs, CO 80923-3503 | 2019-11-07 |
| 1154624302 | Haven Behavioral Outpatient Services of Colorado, LLC | Clinic/Center | 1330 Quail Lake Loop, Suite 200, Colorado Springs, CO 80906-4651 | 2010-12-09 |
| Street Address |
1026 W ABRIENDO AVE |
| City | PUEBLO |
| State | CO |
| Zip Code | 81004-1128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528121688 | Angela M O'neal | Counselor | 1026 W Abriendo Ave, Pueblo, CO 81004-1128 | 2006-12-19 |
| 1336753698 | Family Support Center of Colorado, LLC | Clinic/Center | 1026 W Abriendo Ave, Pueblo, CO 81004-1128 | 2020-09-03 |
| 1477026623 | Alfredo Fuccilli Jr. | Behavioral Analyst | 1026 W Abriendo Ave, Pueblo, CO 81004-1128 | 2019-01-09 |
| 1124522396 | Alexandra Unwin | Behavior Technician | 1026 W Abriendo Ave, Pueblo, CO 81004-1128 | 2018-03-21 |
| 1013411297 | Nicole Salazar | Behavior Technician | 1026 W Abriendo Ave, Pueblo, CO 81004-1128 | 2018-03-21 |
| 1598269862 | Jason Sandoval | Behavior Technician | 1026 W Abriendo Ave, Pueblo, CO 81004-1128 | 2018-03-21 |
| 1598138406 | Blessing Okorougo | Counselor | 1026 W Abriendo Ave, Pueblo, CO 81004-1128 | 2015-11-02 |
| 1043689425 | Katherine Bassett | Registered Nurse | 1026 W Abriendo Ave, Pueblo, CO 81004-1128 | 2015-09-16 |
| 1134597354 | Christina Guerrero | Registered Nurse | 1026 W Abriendo Ave, Pueblo, CO 81004-1128 | 2015-09-03 |
| 1245608462 | Gabrielle Allard | Counselor | 1026 W Abriendo Ave, Pueblo, CO 81004-1128 | 2015-09-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780155929 | Renee C Lane | Nurse Practitioner | 1925 E. Orman Ave. Ste. A109, Pueblo, CO 81004 | 2018-12-16 |
| 1215406913 | Kaiser Foundation Healthplan of Colorado | Pharmacy | 2625 W. Pueblo Blvd, Pueblo, CO 81004 | 2018-11-26 |
| 1053895532 | Rebecka Ann Reatherford | Nurse Practitioner | St Mary-corwin Medical Center, 1008 Minnequa Ave, Pueblo, CO 81004 | 2018-09-20 |
| 1124510821 | Angela M Sillas-green | Counselor | 327 Colorado Ave., Pueblo, CO 81004 | 2018-05-30 |
| 1558898569 | Alexandra R B King | Family Medicine | Southern Colorado Family Medicine, 902 Lakeview Avenue, Pueblo, CO 81004 | 2017-05-22 |
| 1578098752 | James Williams | Counselor | 414 Broadway Ave, Pueblo, CO 81004 | 2017-04-26 |
| 1740732601 | Valerie A Senger | Counselor | 635 W Corona Ave Ste 214, Pueblo, CO 81004 | 2016-10-26 |
| 1194111500 | A New Leaf Therapy, Pllc | Community/Behavioral Health | 327 Colorado Ave, Pueblo, CO 81004 | 2015-04-13 |
| 1619371671 | Mariah Mcginnis | Registered Nurse | 1232 Van Buren St., Pueblo, CO 81004 | 2014-10-20 |
| 1730593112 | Maritza Martinez | Registered Nurse | 1026 Wabriendo Ave, Pueblo, CO 81004 | 2014-06-13 |
| Find all providers in zip 81004 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235697616 | Health Solutions | Clinic/Center | 41 Montebello Rd Ste 120, Pueblo, CO 81001-1366 | 2019-03-05 |
| 1790262376 | Connecting Point Counseling Services | Clinic/Center | 503 N Main St Ste 324, Pueblo, CO 81003-3139 | 2018-07-26 |
| 1457419830 | Health Solutions | Clinic/Center | 2003 E 4th St, Pueblo, CO 81001-4150 | 2006-12-05 |
| 1689732075 | Health Solutions | Clinic/Center | 512 Henry Ave, Pueblo, CO 81005-1707 | 2006-12-05 |
| 1457950958 | State of Grace | Clinic/Center | 720 N Main St Ste 330, Pueblo, CO 81003-3047 | 2020-10-26 |
| 1700483187 | Health Solutions | Clinic/Center | 41 Montebello Rd, Pueblo, CO 81001-1379 | 2020-10-08 |
| 1366049744 | Health Solutions | Clinic/Center | 1304 Chinook Ln, Pueblo, CO 81001-1851 | 2020-10-08 |
| 1053918623 | Health Solutions | Clinic/Center | 1591 Taos Rd, Pueblo, CO 81006-1232 | 2020-10-06 |
| 1225635113 | Health Solutions | Clinic/Center | 1304 Chinook Ln, Pueblo, CO 81001-1851 | 2020-10-05 |
| 1952908840 | Health Solutions | Clinic/Center | 41 Montebello Rd, Pueblo, CO 81001-1379 | 2020-10-05 |
| Find all providers in PUEBLO | ||||
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| 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.