Provider Demographics
NPI:1326417833
Name:HUERFANO COUNTY DEPT. OF SOCIAL SERVICES
Entity Type:Organization
Organization Name:HUERFANO COUNTY DEPT. OF SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUDSON-MACCHIETTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-738-2810
Mailing Address - Street 1:121 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WALSENBURG
Mailing Address - State:CO
Mailing Address - Zip Code:81089-2201
Mailing Address - Country:US
Mailing Address - Phone:719-738-2810
Mailing Address - Fax:719-738-2549
Practice Address - Street 1:121 W 6TH ST
Practice Address - Street 2:
Practice Address - City:WALSENBURG
Practice Address - State:CO
Practice Address - Zip Code:81089-2201
Practice Address - Country:US
Practice Address - Phone:719-738-2810
Practice Address - Fax:719-738-2549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06200281Medicaid