Organization
BRIDGE TO AWARENESS COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE DARR (DIRECTOR)
(719) 471-2514
Entity
Organization
Contact information
Practice address
310 W C ST, PUEBLO, CO 81003-3409
(719) 296-1366
(719) 296-6825
Mailing address
310 W C ST, PUEBLO, CO 81003-3409
(719) 296-1366
(719) 296-6825
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1110-02
CO
251S00000X
Community/Behavioral Health Agency
1110-02
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04433262
—
CO
Enumeration date
12/09/2008
Last updated
12/09/2008
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