Organization
VALLEY COMMUNITY COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY EUGENE KELLEY MA, LPC, NCC (OWNER)
(719) 469-0799
Entity
Organization
Contact information
Practice address
313 W 3RD STREET LINCOLN SQUARE PROFESSIONAL BUILDING, SUITE 204, LA JUNTA, CO 81050
(719) 469-0799
Mailing address
313 W 3RD STREET LINCOLN SQUARE PROFESSIONAL BUILDING, SUITE 204, LA JUNTA, CO 81050
(719) 469-0799
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
3479
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174817605
VALUE OPTIONS
CO
05
—
1174817605
—
CO
Enumeration date
06/01/2011
Last updated
09/15/2011
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