Peaceful Spirit/Sucap

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

1390 Issued in 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

Last updated

Apr 13, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Dennis William Dahlke, MED, CACIII, LPC

Title

Program Director

Phone

(970) 563-4555

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• June Barrie Santon, M.A.

  • Mental Health Counselor
  • Ignacio, CO
  • NPI 1275776734
  NPD (past)
• Galina Wood, B.S.

  • Addiction (Substance Use Disorder) Counselor
  • Ignacio, CO
  • NPI 1801026331
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239580800000",
    "number": "1104069764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 429",
            "city": "IGNACIO",
            "state": "CO",
            "postal_code": "811370429",
            "telephone_number": "970-563-4555",
            "fax_number": "970-563-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 MOUACHE DRIVE",
            "city": "IGNACIO",
            "state": "CO",
            "postal_code": "811370429",
            "telephone_number": "970-563-4555",
            "fax_number": "970-563-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL SPIRIT/SUCAP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-13",
        "last_updated": "2009-04-13",
        "status": "A",
        "authorized_official_last_name": "DAHLKE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "970-563-4555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MED, CACIII, LPC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CO",
            "license": "1390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO STATE DEPARTMENT OF REGLATORY AGENCY",
            "identifier": "1390",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Notramic LLC
• Hannah Marie Nusz, LMSW
• Lars Olson, LP
• Danielle Ortega, PA-C
• Peaceful Spirit
• Rebecca Ledford LLC
• Karen Wendy Rice, R.D.
• Amber Richardson, LPCC
• Nenette Robinson, FNP-C
• Anne Vandegrift Rotondi, LM

• Substance Abuse Rehabilitation Facility in Ignacio, CO
• Providers in Ignacio, CO by specialty
• Substance Abuse Rehabilitation Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.