| Southwest Colorado Dbt Llc | |
|
1309 E 3rd Ave Unit B-5 Durango CO 81301-5255 | |
| (414) 315-0897 | |
| (970) 459-1141 |
| Full Name | Southwest Colorado Dbt Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1309 E 3rd Ave Unit B-5, Durango, Colorado |
| Authorized Official Name and Position | Lynne M Rosenberg (OWNER) |
| Authorized Official Contact | 4143150897 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Colorado Dbt Llc 1309 E 3rd Ave Unit B-5 Durango CO 81301-5255 Ph: (414) 315-0897 | Southwest Colorado Dbt Llc 1309 E 3rd Ave Unit B-5 Durango CO 81301-5255 Ph: (414) 315-0897 |
| NPI Number | 1710631379 |
|---|---|
| Provider Enumeration Date | 02/11/2022 |
| Last Update Date | 02/11/2022 |
| Certification Date | 01/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710631379 | NPI | - | NPPES |
| 1225620172 | Medicaid | CO | |
| 1114449063 | Medicaid | CO | |
| 1336586981 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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