Child Adolescent Services | |
1600 W 24th St Pueblo CO 81003-1411 | |
(719) 546-4000 | |
(719) 546-4484 |
Full Name | Child Adolescent Services |
---|---|
Speciality | Psychiatric Unit |
Location | 1600 W 24th St, Pueblo, Colorado |
Authorized Official Name and Position | Kat Foo (HIPAA OFFICER) |
Authorized Official Contact | 3038665871 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Child Adolescent Services 1600 W 24th St Pueblo CO 81003-1411 Ph: (719) 546-4000 | Child Adolescent Services 1600 W 24th St Pueblo CO 81003-1411 Ph: (719) 546-4000 |
NPI Number | 1043342793 |
---|---|
Provider Enumeration Date | 03/09/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043342793 | NPI | - | NPPES |
05640016 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
273R00000X | Psychiatric Unit | 0236 (Colorado) | Primary |
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