Springs Behavioral Health LLC

Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Colorado Springs, CO

NPI 1801471982 · NPPES record last updated Jan 2, 2025

Key facts

NPI
1801471982
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Legal business name
SPRINGS BEHAVIORAL HEALTH LLC
Practice address
1465 Kelly Johnson Blvd Ste 305
Colorado Springs, CO 80920-3947
Phone
(719) 495-3359
Fax
(719) 691-7003
NPI assigned
Mar 10, 2021
Organization subpart
No

Authorized official

Name
Dr. Omar Ahmed Khan, DNP
Title
Ceo
Phone
(719) 495-3359

Practitioners 7

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210505000863 CO Part B Supplier - Clinic/Group Practice 8820407703 Receives reassigned benefits from 6 practitioners
Practice locations: Colorado Springs, CO

National Provider Directory

Locations

1465 Kelly Johnson Blvd
Ste 245
Colorado Springs, CO 80920

1465 Kelly Johnson Blvd
Ste 305
Colorado Springs, CO 80920
Phone (719) 362-0796

1465 Kelly Johnson Blvd
Ste 320
Colorado Springs, CO 80920
Phone (719) 495-3359

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363LP0808X Yes

Addresses

Primary practice location

1465 Kelly Johnson Blvd Ste 305
Colorado Springs, CO 80920-3947

Mailing address

1465 Kelly Johnson Blvd Ste 305
Colorado Springs, CO 80920-3947
Phone (719) 495-3359

Other identifiers

IdentifierTypeStateIssuer
9000192341MedicaidCO

Other providers in Colorado Springs, CO

All providers in Colorado Springs, CO · Psychiatric/Mental Health Nurse Practitioner in Colorado

Sources for this page

Verify at the official NPI Registry.