Organization
STATE OF COLORADO
Active
Other names
Otero Junior College Child Development Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES RIZZUTO (PRESIDENT)
(719) 384-6822
Entity
Organization
Contact information
Practice address
1802 COLORADO AVE, LA JUNTA, CO 81050-3400
(719) 384-3102
(719) 384-1096
Mailing address
1802 COLORADO AVE, LA JUNTA, CO 81050-3400
(719) 384-3102
(719) 384-1096
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
06D1089569
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94654395
—
CO
Enumeration date
09/23/2008
Last updated
09/23/2008
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