Organization
MESA DEVELOPMENTAL SERVICES
Active
Other names
1444 N. 23rd St
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER BRANDON BERGQUIST AO (CFO)
(970) 256-8603
Entity
Organization
Contact information
Practice address
1444 N 23RD ST, GRAND JUNCTION, CO 81501-6546
(970) 254-9378
(970) 255-6462
Mailing address
790 WELLINGTON AVE, GRAND JUNCTION, CO 81501-6126
(970) 256-8637
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
76135098
—
CO
Enumeration date
04/12/2019
Last updated
08/30/2021
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