Organization
JAYWALKER LODGE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURI WINSLOW (DIRECTOR OF INSURANCE)
(970) 704-9292
Entity
Organization
Contact information
Practice address
725 MAIN ST, CARBONDALE, CO 81623
(970) 704-9292
Mailing address
PO BOX 969, CARBONDALE, CO 81623-0969
(970) 704-9292
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
12/05/2014
Last updated
06/26/2020
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