Organization
PUEBLO COMMUNITY CONNECTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEE LAVINE (DIRECTOR)
(719) 544-2122
Entity
Organization
Contact information
Practice address
3913 SANDLEWOOD LN, PUEBLO, CO 81005-2586
(719) 544-2122
Mailing address
PO BOX 3157, PUEBLO, CO 81005-0157
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
1524719
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13600273
—
CO
Enumeration date
03/05/2007
Last updated
06/02/2008
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