Organization
PROJECT PUEBLO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EARL R POTEET LCSW (PRESIDENT)
(303) 908-8623
Entity
Organization
Contact information
Practice address
117 FAIRWAY VLG, PUEBLO WEST, CO 81007-3621
(303) 908-8623
Mailing address
117 FAIRWAY VLG, PUEBLO WEST, CO 81007-3621
(303) 908-8623
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CSW 1809
CO
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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