Organization
POSITIVE BEHAVIORAL SERVICES OF THE FOUR CORNERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK HOLTON (OWNER)
(970) 946-1539
Entity
Organization
Contact information
Practice address
23 S BEECH ST STE B102, CORTEZ, CO 81321-3751
(970) 946-1539
Mailing address
23 S BEECH ST STE B102, CORTEZ, CO 81321-3751
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121212
—
CO
Enumeration date
11/16/2015
Last updated
11/20/2018
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