Provider First Line Business Practice Location Address:
1600 WEST 24TH STREET
Provider Second Line Business Practice Location Address:
COLORADO MENTAL HEALTH INSTITUTE AT PUEBLO
Provider Business Practice Location Address City Name:
PUEBLO
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-761-1486
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/22/2010