Organization
SOUTHEAST MENTAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL A ARAGON (CREDENTIALING SPECIALIST)
(719) 383-5408
Entity
Organization
Contact information
Practice address
14833 S RITTGERS ST, EADS, CO 81036-9514
(719) 384-5446
Mailing address
711 BARNES AVE, LA JUNTA, CO 81050-2138
(719) 384-5446
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04160099
—
CO
Enumeration date
12/03/2020
Last updated
12/03/2020
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