Provider Demographics
NPI:1992550966
Name:COUNTY OF LA PLATA
Entity type:Organization
Organization Name:COUNTY OF LA PLATA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANSELMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-382-6180
Mailing Address - Street 1:C/O CLINICAL SERVICES - 150 MERCURY VILLAGE DRIVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-8955
Mailing Address - Country:US
Mailing Address - Phone:970-828-8850
Mailing Address - Fax:970-247-9126
Practice Address - Street 1:150 MERCURY VILLAGE DR STE 115
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-8955
Practice Address - Country:US
Practice Address - Phone:970-828-8850
Practice Address - Fax:970-247-9126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No1223D0001XDental ProvidersDentistDental Public Health
No332900000XSuppliersNon-Pharmacy Dispensing Site