Provider Demographics
NPI:1851568737
Name:RURAL TREATMENT SERVICES
Entity Type:Organization
Organization Name:RURAL TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ABRAHAM
Authorized Official - Last Name:WOLFSOHN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:720-220-8651
Mailing Address - Street 1:1000 LINCOLN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:FORT MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701-3290
Mailing Address - Country:US
Mailing Address - Phone:720-220-8651
Mailing Address - Fax:303-766-2457
Practice Address - Street 1:1000 LINCOLN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-3290
Practice Address - Country:US
Practice Address - Phone:720-220-8651
Practice Address - Fax:303-766-2457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-10
Last Update Date:2008-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1376103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty