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Organization
SAN JUAN YOUTH WORKS
Active
Organization
SAN JUAN YOUTH WORKS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TRUITT (DIRECTOR)
(719) 852-4799
Entity
Organization
Contact information
Practice address
260 ADAMS ST, MONTE VISTA, CO 81144-1424
(719) 852-4799
(719) 852-5369
Mailing address
260 ADAMS ST, PO BOX 466, MONTE VISTA, CO 81144-1424
(719) 852-4799
(719) 852-5369
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
1501942
CO
Other
Enumeration date
04/14/2008
Last updated
04/14/2008
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