Organization
TRI COUNTY HOUSING & CDC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON WAYNE RAY (REHAB COORDINATOR)
(719) 263-5168
Entity
Organization
Contact information
Practice address
34385 HWY 167, FOWLER, CO 81039-0087
(719) 263-5168
(719) 263-5460
Mailing address
PO BOX 87, FOWLER, CO 81039-0087
(719) 263-5168
(719) 263-5460
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Enumeration date
07/10/2017
Last updated
06/16/2018
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