Provider Demographics
NPI:1992752133
Name:CEDAR SPRINGS HOSPITAL, INC
Entity type:Organization
Organization Name:CEDAR SPRINGS HOSPITAL, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VP CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-738-3300
Mailing Address - Street 1:PO BOX 841005
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1005
Mailing Address - Country:US
Mailing Address - Phone:719-633-4114
Mailing Address - Fax:719-578-5407
Practice Address - Street 1:2135 SOUTHGATE RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-2605
Practice Address - Country:US
Practice Address - Phone:719-633-4114
Practice Address - Fax:719-578-5407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1099261QM0801X, 283Q00000X
CO1517006323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05123313Medicaid
CO24174203Medicaid
CO1517006Medicaid
064009Medicare Oscar/Certification