| Sucap | |
|
296 Mouache Rd. Ignacio CO 81137-0429 | |
| (970) 563-4555 | |
| (970) 563-4618 |
| Full Name | Sucap |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 296 Mouache Rd., Ignacio, Colorado |
| Authorized Official Name and Position | Elaine Wasserbach (DIRECTOR) |
| Authorized Official Contact | 9705634517 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sucap 296 Mouache Rd. Ignacio CO 81137-0429 Ph: (970) 563-4555 | Sucap 296 Mouache Rd. Ignacio CO 81137-0429 Ph: (970) 563-4555 |
| NPI Number | 1033352240 |
|---|---|
| Provider Enumeration Date | 04/17/2009 |
| Last Update Date | 04/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033352240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1445 (Colorado) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | 116600 (Colorado) | Secondary |
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