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NPI Code Detail

MEDICARE: MRS. BETTY JEAN MARTINEZ RESIDENTIAL COUNSELO

MEDICARE: MRS. BETTY JEAN MARTINEZ RESIDENTIAL COUNSELO
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1083055032
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BETTY JEAN MARTINEZ RESIDENTIAL COUNSELO
Provider Business Mailing Address
First Line : 322 SUNSET DR
Second Line :
City : LA SALLE
State : CO
Zip : 80645-3082
Country : US
Telephone Number : 970-284-5285
Fax Number : 970-284-5258
Provider Business Practice Location Address
First Line : 1512 MONACO PKWY
Second Line :
City : DENVER
State : CO
Zip : 80220-1641
Country : US
Telephone Number : 970-284-5258
Fax Number : 970-284-5285
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2013
Last Update Date : 07/07/2013

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