Organization
RIO GRANDE OLTC
Active
Other names
Rio Grande County
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE L. STEPHENS (LONG TERM CARE MANAGER)
(719) 657-4208
Entity
Organization
Contact information
Practice address
925 6TH ST, DEL NORTE, CO 81132-3252
(719) 657-4208
Mailing address
925 6TH ST, DEL NORTE, CO 81132-3252
(719) 657-4208
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
04/11/2007
Last updated
06/25/2008
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