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Organization
SOUTHEAST MENTAL HEALTH SERVICES
Active
Organization
SOUTHEAST MENTAL HEALTH SERVICES
Active
Parent organization
SOUTHEAST MENTAL HEALTH SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEAST MENTAL HEALTH SERVICES
Authorized official
LISA CHAVEZ (CONTRACT & CREDENTIALING MANAGER)
(719) 383-5448
Entity
Organization
Contact information
Practice address
100 KENDALL DR., LAMAR, CO 81052-3901
(719) 384-5446
(719) 384-5672
Mailing address
711 BARNES AVE, LA JUNTA, CO 81050-2138
(719) 384-5446
(719) 384-5672
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
880078
—
CO
Enumeration date
09/12/2019
Last updated
09/13/2022
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