Provider Demographics
NPI:1962083667
Name:KIDS CROSSING
Entity type:Organization
Organization Name:KIDS CROSSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDGES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-667-7063
Mailing Address - Street 1:1440 E FOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3502
Mailing Address - Country:US
Mailing Address - Phone:719-632-4569
Mailing Address - Fax:
Practice Address - Street 1:5040 CORPORATE PLAZA DR STE 7E
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-6100
Practice Address - Country:US
Practice Address - Phone:719-249-7896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIDS CROSSING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000176191Medicaid