NPI 1124757745

Jordan Residential & Vocational Services INC.

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Pueblo, CO

Practice location

Address: 2928 Withers Ave, Pueblo, CO 81008-1248
Phone: (719) 543-8178
Fax: (719) 545-8583
Mailing address: PO Box 8477, Pueblo, CO 81008-8477

Authorised official

Name: Mike Edward Jordan
Title: Owner
Phone: (719) 251-4604

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

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Registry record

NPI: 1124757745
Entity type: Organization
NPI issued: 8 Jun 2022
Record last updated: 8 Jun 2022

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.