Provider Demographics
NPI:1750752390
Name:MESA COUNTY DEPT OF HUMAN SERVICES
Entity type:Organization
Organization Name:MESA COUNTY DEPT OF HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-248-2810
Mailing Address - Street 1:510 29 1/2 RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-5383
Mailing Address - Country:US
Mailing Address - Phone:970-683-2631
Mailing Address - Fax:970-255-3608
Practice Address - Street 1:510 29 1/2 RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-5383
Practice Address - Country:US
Practice Address - Phone:970-683-2631
Practice Address - Fax:970-255-3608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06200398Medicaid