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NPI Code Detail

MEDICARE: CENTRO DE LA FAMILIA

MEDICARE: CENTRO DE LA FAMILIA
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
1101YM0800XMental Health CounselorCSW-991418CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639413248
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRO DE LA FAMILIA
Provider Business Mailing Address
First Line : PO BOX 15005
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80935-5005
Country : US
Telephone Number : 719-238-8638
Fax Number : 719-227-9185
Provider Business Practice Location Address
First Line : 1645 S MURRAY BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80916-4502
Country : US
Telephone Number : 719-238-8638
Fax Number : 719-227-9185
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. LUCIA GUILLEN
Credential : M.A
Telephone Number : 719-238-8638
Provider Enumeration Date : 11/20/2012
Last Update Date : 09/28/2020

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Directions to “CENTRO DE LA FAMILIA ” Practice Location

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