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NPI Code Detail

MEDICARE: DANCO SUPPORTIVE SERVICES COLORADO INC

MEDICARE: DANCO SUPPORTIVE SERVICES COLORADO INC
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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center1985-01CO

General Provider Information

NPI Number : 1558850339
Entity Type Code : Organization
Provider Name (Legal Business Name) : DANCO SUPPORTIVE SERVICES COLORADO INC
Provider Business Mailing Address
First Line : 3302 SOUTH GRAND AVENUE
Second Line :
City : GLENWOOD SPRINGS
State : CO
Zip : 81601
Country : US
Telephone Number : 970-930-6355
Fax Number : 970-366-3929
Provider Business Practice Location Address
First Line : 3302 SOUTH GRAND AVENUE
Second Line :
City : GLENWOOD SPRINGS
State : CO
Zip : 81601
Country : US
Telephone Number : 970-930-6355
Fax Number : 970-366-3929
Authorized Official
Title or Position : PROGRAM DIRECTOR
Name : AMANDA LEIGH OWENSBY
Credential : CAC II
Telephone Number : 970-930-6355
Provider Enumeration Date : 05/07/2018
Last Update Date : 07/18/2018

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Directions to “DANCO SUPPORTIVE SERVICES COLORADO INC ” Practice Location

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