Provider Demographics
NPI:1396289955
Name:STEL, LLC
Entity type:Organization
Organization Name:STEL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CIO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MOCKLEY
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:970-366-0494
Mailing Address - Street 1:989 S MAIN ST STE A
Mailing Address - Street 2:#455
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-4602
Mailing Address - Country:US
Mailing Address - Phone:855-925-5267
Mailing Address - Fax:855-920-8038
Practice Address - Street 1:520 S 3RD ST
Practice Address - Street 2:STE 12
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-2059
Practice Address - Country:US
Practice Address - Phone:855-925-5267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1825-00261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder