Provider Demographics
NPI:1255422788
Name:SOUTHERN COLORADO UTE SERVICE UNIT
Entity type:Organization
Organization Name:SOUTHERN COLORADO UTE SERVICE UNIT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:
Authorized Official - Last Name:LANSING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-565-4441
Mailing Address - Street 1:PO BOX 49
Mailing Address - Street 2:
Mailing Address - City:TOWAOC
Mailing Address - State:CO
Mailing Address - Zip Code:81334-0049
Mailing Address - Country:US
Mailing Address - Phone:970-565-4441
Mailing Address - Fax:970-565-4784
Practice Address - Street 1:232 RUSTLING WILLOW ST
Practice Address - Street 2:
Practice Address - City:TOWAOC
Practice Address - State:CO
Practice Address - Zip Code:81334-0049
Practice Address - Country:US
Practice Address - Phone:970-565-4441
Practice Address - Fax:970-565-9110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0904XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, Federal
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT700000000009Medicaid
AZ708000Medicaid
CO05600002Medicaid
NMG7123Medicaid
CO05600002Medicaid
NM320057Medicare Oscar/Certification