Provider Demographics
NPI:1740755172
Name:RIO BLANCO COUNSELING LLC
Entity Type:Organization
Organization Name:RIO BLANCO COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:970-230-5827
Mailing Address - Street 1:1157 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:MEEKER
Mailing Address - State:CO
Mailing Address - Zip Code:81641-3207
Mailing Address - Country:US
Mailing Address - Phone:970-230-5827
Mailing Address - Fax:970-238-5848
Practice Address - Street 1:592 MAIN ST
Practice Address - Street 2:
Practice Address - City:MEEKER
Practice Address - State:CO
Practice Address - Zip Code:81641-8164
Practice Address - Country:US
Practice Address - Phone:970-230-5827
Practice Address - Fax:970-230-5848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health