Provider Demographics
NPI:1992962898
Name:GUNNISON HINSDALE DEPT OF HUMAN SERVICES
Entity type:Organization
Organization Name:GUNNISON HINSDALE DEPT OF HUMAN SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR GCDHS
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:970-641-3244
Mailing Address - Street 1:225 N PINE ST
Mailing Address - Street 2:STE A
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2648
Mailing Address - Country:US
Mailing Address - Phone:970-641-3244
Mailing Address - Fax:970-641-3738
Practice Address - Street 1:225 N PINE ST
Practice Address - Street 2:STE A
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2648
Practice Address - Country:US
Practice Address - Phone:970-641-3244
Practice Address - Fax:970-641-3738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO06200265343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06200265Medicaid