# SAN JUAN YOUTH WORKS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376717009
- **Authorized official:** MICHAEL TRUITT (DIRECTOR)
- **Authorized official phone:** (719) 852-4799

## Contact information

- **Practice address:** 260 ADAMS ST, MONTE VISTA, CO 81144-1424
- **Practice address phone:** (719) 852-4799
- **Practice address fax:** (719) 852-5369
- **Mailing address:** 260 ADAMS ST, PO BOX 466, MONTE VISTA, CO 81144-1424
- **Mailing address phone:** (719) 852-4799
- **Mailing address fax:** (719) 852-5369

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | 1501942 | CO | Yes |

## Other

- **Enumeration date:** 04/14/2008
- **Last updated:** 04/14/2008