| Mountain Family Living, A Prof Corp | |
| 
					167 N Cora, Ste 2 Ridgway CO 81432  | |
| (970) 626-4202 | |
| Not Available | 
| Full Name | Mountain Family Living, A Prof Corp | 
|---|---|
| Speciality | Community/behavioral Health | 
| Location | 167 N Cora, Ste 2, Ridgway, Colorado | 
| Authorized Official Name and Position | Randolph - Stanko (PRESIDENT) | 
| Authorized Official Contact | 9706264202 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mountain Family Living, A Prof Corp 160 N Cora, Ste 2 Po Box 698 Ridgway CO 81432 Ph: (970) 626-4202  | Mountain Family Living, A Prof Corp 167 N Cora, Ste 2 Ridgway CO 81432 Ph: (970) 626-4202  | 
| NPI Number | 1679608137 | 
|---|---|
| Provider Enumeration Date | 02/23/2007 | 
| Last Update Date | 08/22/2020 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1679608137 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LMFT193 (Colorado) | Primary | 
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