Provider Demographics
NPI:1992972731
Name:PARKVIEW ANCILLARY SERVICES
Entity type:Organization
Organization Name:PARKVIEW ANCILLARY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-584-4000
Mailing Address - Street 1:1600 N GRAND AVE
Mailing Address - Street 2:STE 150
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-2700
Mailing Address - Country:US
Mailing Address - Phone:719-595-7705
Mailing Address - Fax:719-595-7719
Practice Address - Street 1:56 CLUB MANOR DR
Practice Address - Street 2:STE 100
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-1679
Practice Address - Country:US
Practice Address - Phone:719-584-4767
Practice Address - Fax:719-584-4808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty