Provider Demographics
NPI:1437326097
Name:COMMUNITY HEALTH INITIATIVES
Entity Type:Organization
Organization Name:COMMUNITY HEALTH INITIATIVES
Other - Org Name:PATHWAYS ADOLESCENT RECOVERY PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:970-945-2614
Mailing Address - Street 1:0189 JW DRIVE UNIT B SUITE 2-3
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-8776
Mailing Address - Country:US
Mailing Address - Phone:970-963-6013
Mailing Address - Fax:970-963-6015
Practice Address - Street 1:2001 BLAKE AVE SUITE 1A
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601
Practice Address - Country:US
Practice Address - Phone:970-945-2614
Practice Address - Fax:970-947-9158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6566261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder