Organization
MOUNTAIN FAMILY LIVING, A PROF CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDOLPH - STANKO LMFT (PRESIDENT)
(970) 626-4202
Entity
Organization
Contact information
Practice address
167 N CORA, STE 2, RIDGWAY, CO 81432
(970) 626-4202
Mailing address
160 N CORA, STE 2, PO BOX 698, RIDGWAY, CO 81432
(970) 626-4202
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LMFT193
CO
Other
Enumeration date
02/23/2007
Last updated
08/22/2020
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