Provider Demographics
NPI:1720804941
Name:ALL-TERRAIN BEHAVIOR HEALTH GROUP
Entity type:Organization
Organization Name:ALL-TERRAIN BEHAVIOR HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:719-229-8879
Mailing Address - Street 1:6805 CORPORATE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1977
Mailing Address - Country:US
Mailing Address - Phone:719-726-8811
Mailing Address - Fax:
Practice Address - Street 1:1834 VINEWOOD LN STE 214
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81005-2559
Practice Address - Country:US
Practice Address - Phone:719-726-8811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)