ROCK BOTTOM RECOVERY PLACE, LLC


Address: 6910 Bandley Dr, Suite 135, Fountain, CO 80817-2617
Phone: 7193825778

ROCK BOTTOM RECOVERY PLACE, LLC (NPI# 1407141260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407141260
Entity Type Organization
Organization Name ROCK BOTTOM RECOVERY PLACE, LLC
Practice Address 6910 Bandley Dr
Suite 135
Fountain
CO 80817-2617
Practice Telephone 7193825778
Practice Fax Number 7193908239
Mailing Telephone 7193825778
Mailing Fax Number 7193908239
Enumeration Date 2011-06-09
Last Update Date 2011-06-09
Authorized Official Name DOLORES J WALKER (CEO, DIR. CLINICAL SERVICES)
Authorized Official Telephone 7193825778
Authorized Official Credential MA
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
160701 CO Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CO NAADAC MASTER ADDICTION COUNSELOR 507105 01
CO LICENSED PROFESSIONAL COUNSELOR 4306 01

Office Location

Street Address 6910 BANDLEY DR
SUITE 135
City FOUNTAIN
State CO
Zip Code 80817-2617

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NPI Name Taxonomy Address Enumeration
1942235759 Southern Colorado Joint Ventures LLC Clinic/Center 6910 Bandley Dr, Fountain, CO 80817 2006-07-11

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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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Competitor

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City FOUNTAIN
Zip Code 80817

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Dataset Information

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.

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