| NPI | 1588415517 |
|---|---|
| Doing Business As | MARC PUEBLO MH |
| Entity Type | Organization |
| Authorized Contact | JENNIFER RUDNIK Credentialing Manager 719-423-1341 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2025-01-22 |