NPI 1104069764

Peaceful Spirit/Sucap

Organisation Substance Abuse Rehabilitation Facility Ignacio, CO

Practice location

Address: 296 Mouache Drive, Ignacio, CO 81137-0429
Phone: (970) 563-4555
Fax: (970) 563-4618
Mailing address: PO Box 429, Ignacio, CO 81137-0429

Authorised official

Name: Dennis William Dahlke
Title: Program Director
Phone: (970) 563-4555

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X Licence 1390 (CO)

Other Substance Abuse Rehabilitation Facility providers in Colorado →

Registry record

NPI: 1104069764
Entity type: Organization
NPI issued: 13 Apr 2009
Record last updated: 13 Apr 2009

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.