| Bridge To Awareness Counseling Center, Inc | |
|
129 W Costilla St Colorado Springs CO 80903-3813 | |
| (719) 471-2514 | |
| Not Available |
| Full Name | Bridge To Awareness Counseling Center, Inc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 129 W Costilla St, Colorado Springs, Colorado |
| Authorized Official Name and Position | Charles Stephen Darr (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7194712514 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridge To Awareness Counseling Center, Inc 129 W Costilla St Colorado Springs CO 80903-3813 Ph: (719) 471-2514 | Bridge To Awareness Counseling Center, Inc 129 W Costilla St Colorado Springs CO 80903-3813 Ph: (719) 471-2514 |
| NPI Number | 1447389382 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 09/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447389382 | NPI | - | NPPES |
| 95527338 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1110-00 (Colorado) | Primary |
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