Providence Recovery Service of Colorado LLC

NPI #1306408216 in Craig, Colorado

Provider Information

NPI Number: 1306408216
Entity Type: Organization
Organization Name: Providence Recovery Service of Colorado LLC
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Enumeration Date: Jul 1, 2019
Last Updated: Feb 26, 2020

Practice Location

Address: 390 YAMPA BOULEVARD
City: Craig
State: Colorado
ZIP Code: 81625-2600
Phone: (709) 824-5433

Authorized Official

Name: MRS. TINA RENE VEST
Title: BILLING DIRECTOR
Phone: (662) 625-7111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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MR. Brice Duvall Glasscock, CAS, NCAC I	Counselor - Addiction (Substance Use Disorder)	Craig	AI Deep Dive
Tracey H Lathrop, CAC	Counselor - Addiction (Substance Use Disorder)	Craig	AI Deep Dive
MS. Juanita June Huwa, MA,, CAC III, LPC	Counselor - Addiction (Substance Use Disorder)	Greeley	AI Deep Dive
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Clarity Counseling P.c.	Counselor - Addiction (Substance Use Disorder)	Lake City	AI Deep Dive

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