Healthcare Provider Details

I. General information

NPI: 1295864270
Provider Name (Legal Business Name): RIO BLANCO COUNTY SCHOOL DISTRICT RE-4
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 RIVER RD
RANGELY CO
81648-2205
US

IV. Provider business mailing address

550 RIVER RD
RANGELY CO
81648-2205
US

V. Phone/Fax

Practice location:
  • Phone: 970-675-2207
  • Fax:
Mailing address:
  • Phone: 970-675-2207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateCO

VIII. Authorized Official

Name: MS. DONNA DAY
Title or Position: RIO BLANCO BOCES EXECUTIVE DIR
Credential:
Phone: 970-675-2064