Organization
SOUTHERN COLORADO COMPREHENSIVE COURT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY JAMES RUSOVICK M.A. CACIII (DIRECTOR)
(719) 334-1010
Entity
Organization
Contact information
Practice address
200 W B ST STE 226, PUEBLO, CO 81003-3574
(719) 595-1634
(719) 595-1643
Mailing address
200 W B ST STE 226, PUEBLO, CO 81003-3574
(719) 595-1634
(719) 595-1643
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
139100
CO
Other
Enumeration date
09/07/2011
Last updated
09/07/2011
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