| Doctor Name: | MICHAEL ANTHONY JOSEPH |
| NPI Number: | 1568605012 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CACIII |
| License Number: | 116600 |
| Business Practice Address: | 296 Mouache Rd. Ignacio, CO - 81137 |
| Business Phone Number: | 9705634555 |
| Business Fax Number: | 9705634618 |
| Mailing Address: | Po Box 3732, DURANGO |
| State: | CO |
| Postal Code: | 813023732 |
| Phone Number: | 9705530090 |
| Fax Number: | |
| NPI Enumeration Date: | 04/14/2009 |
| NPI Last Update Date: | 04/14/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 324500000X |
| License Number: | 116600 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Substance Abuse Rehabilitation Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |