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11,000 Road Gg.5 Las Animas CO 81054-9488 | |
| (719) 456-2600 | |
| (719) 456-2606 |
| Full Name | |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 11,000 Road Gg.5, Las Animas, Colorado |
| Authorized Official Name and Position | Steven Martinez (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7194562600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
11,000 County Road Gg.5 Las Animas CO 81054 Ph: (719) 456-2600 | 11,000 Road Gg.5 Las Animas CO 81054-9488 Ph: (719) 456-2600 |
| NPI Number | 1992768790 |
|---|---|
| Provider Enumeration Date | 04/11/2006 |
| Last Update Date | 11/26/2024 |
| Certification Date | 11/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992768790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | 1038-00 (Colorado) | Primary |
Southeast Mental Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 437 6th St, Las Animas, CO 81054 Phone: 719-384-5446 Fax: 719-384-5672 | |