STATE OF GRACE

PUEBLO, CO
NPI1164775250
Entity TypeOrganization
Authorized ContactROBERT RICHARD MAES
Clinical Director
719-240-1799
Organization Subpart ?No
Primary Taxonomy251S00000X 
(Licence: CO  1727-01)
Enumeration Date2012-10-26
Last Update Date2021-04-15
Business Address
STATE OF GRACE
720 N MAIN ST STE 330
PUEBLO, CO 81003-3047
Phone number: 719-569-7909
Mailing Address
STATE OF GRACE
720 N MAIN ST STE 330
PUEBLO, CO 81003-3047
Phone number: 719-569-7909
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