| Organization Name: | SPANISH PEAKS MENTAL HEALTH CENTER |
| NPI Number: | 1013076959 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VERONCIA SANDOVAL (ANP) |
| Mailing Address: | 1304 Chinook Ln Pueblo |
| State: | CO US |
| Postal Code: | 810011851 |
| Phone Number: | 7195452746 |
| Fax Number: | 7195840119 |
| NPI Enumeration Date: | 12/06/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 65419 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |