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56 Club Manor Dr Ste 101 Pueblo CO 81008-1679 | |
| (719) 584-4000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 56 Club Manor Dr Ste 101, Pueblo, Colorado |
| Authorized Official Name and Position | Jon E Riggs (CFO) |
| Authorized Official Contact | 7195844000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7901 E Lowry Blvd Mail Stop F402 Denver, Co CO 80230-6507 Ph: () - | 56 Club Manor Dr Ste 101 Pueblo CO 81008-1679 Ph: (719) 584-4000 |
| NPI Number | 1821449471 |
|---|---|
| Provider Enumeration Date | 06/24/2016 |
| Last Update Date | 04/22/2024 |
| Certification Date | 04/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821449471 | NPI | - | NPPES |
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