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NPI Code Detail

MEDICARE: SOUTHWEST COLORADO MENTAL HEALTH CENTER INC

MEDICARE: SOUTHWEST COLORADO MENTAL HEALTH CENTER INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1619761137
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHWEST COLORADO MENTAL HEALTH CENTER INC
Provider Business Mailing Address
First Line : PO BOX 1328
Second Line :
City : DURANGO
State : CO
Zip : 81302-1328
Country : US
Telephone Number : 970-335-2342
Fax Number : 970-335-2438
Provider Business Practice Location Address
First Line : 27B TALISMAN DR UNIT 3
Second Line :
City : PAGOSA SPRINGS
State : CO
Zip : 81147-7914
Country : US
Telephone Number : 970-372-0456
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : JANET ACCOMANDO PETTY
Credential :
Telephone Number : 970-497-6384
Provider Enumeration Date : 04/08/2025
Last Update Date : 12/18/2025

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Directions to “SOUTHWEST COLORADO MENTAL HEALTH CENTER INC ” Practice Location

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