Healthcare Provider Details

I. General information

NPI: 1114072618
Provider Name (Legal Business Name): DELTA COUNTY SOCIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 DODGE ST
DELTA CO
81416-1767
US

IV. Provider business mailing address

560 DODGE ST
DELTA CO
81416-1767
US

V. Phone/Fax

Practice location:
  • Phone: 970-874-2030
  • Fax: 970-874-2068
Mailing address:
  • Phone: 970-874-2030
  • Fax: 970-874-2068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: LEONE ANDERSON
Title or Position: ACCOUNTANT III
Credential:
Phone: 970-874-2030