| Bridge To Awareness Counseling Center | |
|
310 W C St Pueblo CO 81003-3409 | |
| (719) 296-1366 | |
| (719) 296-6825 |
| Full Name | Bridge To Awareness Counseling Center |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 310 W C St, Pueblo, Colorado |
| Authorized Official Name and Position | Steve Darr (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 310 W C St Pueblo CO 81003-3409 Ph: (719) 296-1366 | Bridge To Awareness Counseling Center 310 W C St Pueblo CO 81003-3409 Ph: (719) 296-1366 |
| NPI Number | 1962647685 |
|---|---|
| Provider Enumeration Date | 12/09/2008 |
| Last Update Date | 12/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962647685 | NPI | - | NPPES |
| 04433262 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1110-02 (Colorado) | Primary |
| 251S00000X | Community/behavioral Health | 1110-02 (Colorado) | Secondary |
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