NPI 1043818719
Mike's Place LLC
Practice location
- Address
- 325 Garfield Avenue, Carbondale, CO 81623
- Phone
- (970) 319-8496
- Mailing address
- 323 Garfield Avenue, Carbondale, CO 81623
Authorised official
- Name
- Rebecca L Young
- Title
- Director
- Phone
- (970) 319-8496
Registered specialties (3)
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
Developmentally Disabled Services Day Training Agency
Community/Behavioral Health Agency
Registry record
- NPI
- 1043818719
- Entity type
- Organization
- NPI issued
- 14 Oct 2020
- Record last updated
- 14 Oct 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.