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General NPI Number Information
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NPI Number | 1083918247
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Entity Type | Individual
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Provider Name | LEO PAUL ARGUELLO CAC III #7025
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Gender | Male
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Dates
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Enumeration Date | 01/03/2011
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Last Update Date | 01/03/2011
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Provider Practice Location Address
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Address Line | 1711 EAST EVANS AVENUE CTP, M-IRT
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City | PUEBLO
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State | CO
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Zip | 81004
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Country | US
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Telephone | 719-566-0234
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Fax | 719-564-7212
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Provider Business Mailing Address
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Address Line | 4 MONTEBELLO ROAD CROSSROADS' TURNING POINTS, INC
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City | PUEBLO
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State | CO
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Zip | 81001
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Country | US
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Telephone | 719-546-6667
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Fax | 719-546-8273
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 7025
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License Number State | CO
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