Organization
INSPIRATION FIELD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSA SALO (CFO)
(719) 384-8741
Entity
Organization
Contact information
Practice address
612 ADAMS AVE, LA JUNTA, CO 81050-2535
(719) 384-8741
(719) 384-4278
Mailing address
612 ADAMS AVE, LA JUNTA, CO 81050-2535
(719) 384-8741
(719) 384-4278
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
05023L
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09140054
—
CO
05
—
09145871
—
CO
05
—
09147653
—
CO
Enumeration date
12/31/2015
Last updated
12/31/2015
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