Individual ProviderAlyssa RussoBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address1930 Frequent Flyer Pt, Colorado Springs, CO 80915-1500(800) 345-0448PECOS EnrollmentBased on the most recent information from CMS, provider Alyssa Russo does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1245724400Provider TypeIndividualFull NameRusso, AlyssaGenderFemaleSole ProprietorNoEnumeration Date6/20/2018Last Updated6/20/2018Contact InformationPractice LocationPractice Address1930 Frequent Flyer Pt, Colorado Springs, CO 80915-1500Phone(800) 345-0448FaxUnlisted FaxMailing LocationMailing Address1930 Frequent Flyer Pt, Colorado Springs, CO 80915-1500Phone(800) 345-0448FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer