Organization
WARDOG RANCH REINS OF CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY WARFIELD (CEO)
(760) 449-0367
Entity
Organization
Contact information
Practice address
313 E ABRIENDO AVE, PUEBLO, CO 81004-4212
(760) 449-0367
Mailing address
313 E ABRIENDO AVE, PUEBLO, CO 81004-4212
(760) 449-0367
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
01/11/2023
Last updated
01/11/2023
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