Organization
LUNA COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW THOMASSON (PROGRAM DIRECTOR)
(970) 531-6173
Entity
Organization
Contact information
Practice address
191 EAST AGATE AVE., GRANBY, CO 80446
(970) 531-6173
(970) 887-2293
Mailing address
PO BOX 964, GRAND LAKE, CO 80447-0964
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1655-00
CO
251S00000X
Community/Behavioral Health Agency
Primary
165500
CO
Other
Enumeration date
06/15/2010
Last updated
01/07/2017
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