NPIMap

Organization Active NPI

Rocky Mountain Sober Living LLC

  • Primary Care Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1366216970
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
ROCKY MOUNTAIN SOBER LIVING LLC
Practice address
1716 E Yampa St
Colorado Springs, CO 80909-3855
Phone
(719) 357-6529
NPI assigned
Nov 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Frank Mattice
Title
Owner Operator
Phone
(719) 357-6529

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

1716 E Yampa St
Colorado Springs, CO 80909-3855

Mailing address

1716 E Yampa St
Colorado Springs, CO 80909-3855
Phone (719) 357-6529

Other names 1

  • Rocky Mountain Sober Living LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1366216970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 E YAMPA ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809093855",
            "telephone_number": "719-357-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 E YAMPA ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809093855",
            "telephone_number": "719-357-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN SOBER LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-14",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "MATTICE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "FRANK",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "719-357-6529"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rocky Mountain Sober Living LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rocky Mountain Sober Living LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.