Organization
MESA DEVELOPMENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER BRANDON BERGQUIST (CHIEF FINANCIAL OFFICER)
(970) 256-8603
Entity
Organization
Contact information
Practice address
790 WELLINGTON AVE, GRAND JUNCTION, CO 81501-6126
(970) 256-8637
Mailing address
790 WELLINGTON AVE, GRAND JUNCTION, CO 81501-6126
(970) 256-8637
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000142910
—
CO
Enumeration date
01/13/2020
Last updated
08/30/2021
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