| NPI | 1033430442 |
|---|---|
| Doing Business As | SAN CARLOS CORRECTIONAL FACILITY |
| Entity Type | Organization |
| Authorized Contact | JOANIE SHOEMAKER Director Of Clinical Services 719-226-4535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CO 19512) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2010-06-21 |