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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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