Organization
PROVIDENCE RECOVERY SERVICE OF COLORADO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA RENE VEST (BILLING DIRECTOR)
(662) 625-7111
Entity
Organization
Contact information
Practice address
390 YAMPA BOULEVARD, CRAIG, CO 81625-2600
(709) 824-5433
Mailing address
PO BOX 895, CRAIG, CO 81626-0895
(970) 878-9958
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/01/2019
Last updated
02/26/2020
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