Provider Demographics
NPI:1194104380
Name:EXTON ENTERPRISES, INC.
Entity type:Organization
Organization Name:EXTON ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:EXTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-505-3051
Mailing Address - Street 1:3755 BRIARGATE BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-4195
Mailing Address - Country:US
Mailing Address - Phone:719-505-3051
Mailing Address - Fax:719-213-2305
Practice Address - Street 1:3755 BRIARGATE BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-4195
Practice Address - Country:US
Practice Address - Phone:719-505-3051
Practice Address - Fax:719-213-2305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty