| Pueblo Diversified Industries, Inc. | |
|
2828 Granada Blvd Pueblo CO 81005-3104 | |
| (719) 564-0000 | |
| Not Available |
| Full Name | Pueblo Diversified Industries, Inc. |
|---|---|
| Speciality | Day Training, Developmentally Disabled Services |
| Location | 2828 Granada Blvd, Pueblo, Colorado |
| Authorized Official Name and Position | Bryana Burns (CFO) |
| Authorized Official Contact | 7195640000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pueblo Diversified Industries, Inc. 2828 Granada Blvd Pueblo CO 81005-3104 Ph: (719) 564-0000 | Pueblo Diversified Industries, Inc. 2828 Granada Blvd Pueblo CO 81005-3104 Ph: (719) 564-0000 |
| NPI Number | 1457706483 |
|---|---|
| Provider Enumeration Date | 04/27/2016 |
| Last Update Date | 04/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457706483 | NPI | - | NPPES |
| 09142183 | Medicaid | CO |
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