Organization
COLORADO DEPARTMENT OF CORRECTIONS
Active
Organization
COLORADO DEPARTMENT OF CORRECTIONS
Active
Other names
San Carlos Correctional Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOANIE SHOEMAKER (DIRECTOR OF CLINICAL SERVICES)
(719) 226-4535
Entity
Organization
Contact information
Practice address
1410 W 13TH ST, PUEBLO, CO 81003-1961
(719) 583-5550
(719) 583-5525
Mailing address
1410 W 13TH ST, PUEBLO, CO 81003-1961
(719) 583-5550
(719) 583-5525
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
19512
CO
Other
Enumeration date
06/21/2010
Last updated
06/21/2010
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