Provider Demographics
NPI:1992351969
Name:RESOLUTE YOUTH SERVICES, PLLC
Entity type:Organization
Organization Name:RESOLUTE YOUTH SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RILEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LAC
Authorized Official - Phone:303-335-6098
Mailing Address - Street 1:1473 E 130TH DR
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-1109
Mailing Address - Country:US
Mailing Address - Phone:303-335-6098
Mailing Address - Fax:
Practice Address - Street 1:950 S CHERRY ST STE 419
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-2662
Practice Address - Country:US
Practice Address - Phone:303-335-6098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder