Organization Name: | COMANCHE CROSSING COUNSELING, LLC |
NPI Number: | 1710374640 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARLA M MADRID (OWNER) |
Mailing Address: | 56541 East Colfax Ave. Suite B Strasburg |
State: | CO US |
Postal Code: | 80136 |
Phone Number: | 3036229280 |
Fax Number: | |
NPI Enumeration Date: | 04/17/2015 |
NPI Last Update Date: | 04/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | CSW00001915 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |