Organization
JORDAN RESIDENTIAL & VOCATIONAL SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE EDWARD JORDAN (OWNER)
(719) 251-4604
Entity
Organization
Contact information
Practice address
2928 WITHERS AVE, PUEBLO, CO 81008-1248
(719) 543-8178
(719) 545-8583
Mailing address
PO BOX 8477, PUEBLO, CO 81008-8477
(719) 251-4604
(719) 545-8583
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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