Colorado Department of Corrections
Colorado Department of Corrections is an Exclusive Provider Organization in Pueblo, Colorado. Licensed in Colorado. Registered with an NPI since 2010.
- Licensed in
- CO
- In the registry since
- 2010
Practice location Address checks out
1410 W 13th StPueblo, CO 81003-1961
Phone: (719) 583-5550
Fax: (719) 583-5525
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Exclusive Provider Organization (primary) | Taxonomy 302F00000X · Licence 19512 (CO) |
|---|
Record details
| NPI number | 1033430442 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Joanie Shoemaker — Director Of Clinical Services · (719) 226-4535 |
| Other names | San Carlos Correctional Facility |
| NPI enumerated | June 21, 2010 |
| Last updated in NPPES | June 21, 2010 |
| Mailing address | 1410 W 13th St, Pueblo, CO 81003-1961 |
Other providers in Pueblo
-
Gary Gene Wofford, MD
1600 N Grand Ave #230, Pueblo, CO 81003-2700 · (719) 562-1000