Basic Information
| Provider Information | |||||||||
| NPI: | 1154849545 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PEAK INTERVENTIONS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 421 S TEJON ST STE 140 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809032131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196388844 | ||||||||
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| Practice Location | |||||||||
| Address1: | 421 S TEJON ST STE 140 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809032131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196388844 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | ENOS | ||||||||
| AuthorizedOfficialFirstName: | HEATHER | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7203845312 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TS0200X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | School | 103K00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.