Organization
BRIDGE TO AWARENESS COUNSELING CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES STEPHEN DARR CAC III (EXECUTIVE DIRECTOR)
(719) 471-2514
Entity
Organization
Contact information
Practice address
129 W COSTILLA ST, COLORADO SPRINGS, CO 80903-3813
(719) 471-2514
Mailing address
129 W COSTILLA ST, COLORADO SPRINGS, CO 80903-3813
(719) 471-2514
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1110-00
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95527338
—
CO
Enumeration date
03/05/2007
Last updated
09/29/2016
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