Organization
PEACEFUL SPIRIT
Active
Parent organization
SOUTHERN UTE COMMUNITY ACTION PROGRAM
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN UTE COMMUNITY ACTION PROGRAM
Authorized official
MR. DENNIS W DAHLKE MED, LPC, CAC III (PROGRAM DIRECTOR)
(970) 563-4555
Entity
Organization
Contact information
Practice address
296 MOUACHE, IGNACIO, CO 81137
(970) 563-4555
Mailing address
296 MOUACHE ST., IGNACIO, CO 81137
(970) 563-4555
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1106-00
CO
Other
Enumeration date
05/05/2009
Last updated
05/05/2009
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