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Organization
COUNTY OF COSTILLA
Active
Organization
COUNTY OF COSTILLA
Active
Other names
Costilla County Public Health Agency
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIAN B GALLEGOS RN (DIRECTOR)
(719) 672-3332
Entity
Organization
Contact information
Practice address
233 MAIN STREET, SUITE C, SAN LUIS, CO 81152
(719) 672-3332
(719) 672-3856
Mailing address
233 MAIN STREET, SUITE C, SAN LUIS, CO 81152
(719) 672-3332
(719) 672-3856
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
251K00000X
Public Health or Welfare Agency
Primary
—
NULL
Other
Enumeration date
05/03/2007
Last updated
09/05/2012
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