Provider Demographics
NPI:1548623226
Name:FAMILY ROCS
Entity type:Organization
Organization Name:FAMILY ROCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AFRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CARABALLO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:719-205-1977
Mailing Address - Street 1:108 E CHEYENNE RD
Mailing Address - Street 2:STE 200
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-2504
Mailing Address - Country:US
Mailing Address - Phone:719-205-1977
Mailing Address - Fax:
Practice Address - Street 1:108 E CHEYENNE RD
Practice Address - Street 2:STE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-2504
Practice Address - Country:US
Practice Address - Phone:719-205-1977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty