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General NPI Number Information
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NPI Number | 1437326097
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH INITIATIVES
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 2001 BLAKE AVE SUITE 1A
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601
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Country | US
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Telephone | 970-945-2614
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Fax | 970-947-9158
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Provider Business Mailing Address
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Address Line | 0189 JW DRIVE UNIT B SUITE 2-3
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City | CARBONDALE
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State | CO
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Zip | 81623-8776
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Country | US
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Telephone | 970-963-6013
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Fax | 970-963-6015
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. MICHELE ANN EVANS
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Credential | MA
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Telephone | 970-945-2614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 6566
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License Number State | CO
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