Peaceful Spirit/Sucap
Organization Active NPI Substance Abuse Rehabilitation Facility · Ignacio, CO
NPI 1104069764 · NPPES record last updated Apr 13, 2009
Key facts
- NPI
- 1104069764
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- License
- 1390 (CO)
- Legal business name
- PEACEFUL SPIRIT/SUCAP
- Practice address
- 296 Mouache Drive
Ignacio, CO 81137-0429 - Phone
- (970) 563-4555
- Fax
- (970) 563-4618
- NPI assigned
- Apr 13, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Dennis William Dahlke, MED, CACIII, LPC
- Title
- Program Director
- Phone
- (970) 563-4555
Practitioners 2
-
June Barrie Santon, M.A.
-
Galina Wood, B.S.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | 1390 | CO | Yes |
Addresses
Primary practice location
296 Mouache Drive
Ignacio, CO 81137-0429
Mailing address
PO Box 429
Ignacio, CO 81137-0429
Phone (970) 563-4555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1390 | Other | CO | COLORADO STATE DEPARTMENT OF REGLATORY AGENCY |
Other providers in Ignacio, CO
- Notramic LLC
- Hannah Marie Nusz
- Lars Olson
- Danielle Ortega
- Peaceful Spirit
- Rebecca Ledford LLC
- Karen Wendy Rice
- Amber Richardson
- Nenette Robinson
- Anne Vandegrift Rotondi
All providers in Ignacio, CO · Substance Abuse Rehabilitation Facility in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.