Provider Demographics
NPI:1811409733
Name:SOUTHERN ROCKIES ADDICTION TREATMENT SERVICES
Entity Type:Organization
Organization Name:SOUTHERN ROCKIES ADDICTION TREATMENT SERVICES
Other - Org Name:SUTTLE STREET CLINIC/TMS DURANGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATIVE OPERATIO
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-426-4430
Mailing Address - Street 1:72 SUTTLE ST UNIT M
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-6829
Mailing Address - Country:US
Mailing Address - Phone:970-426-4410
Mailing Address - Fax:970-426-4413
Practice Address - Street 1:72 SUTTLE ST UNIT M
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81303-6829
Practice Address - Country:US
Practice Address - Phone:970-426-4410
Practice Address - Fax:970-426-4413
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHERN ROCKIES ADDICTION TREATMENT SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-01
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty