| NPI | 1003144866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD CHAVEZ Director 719-231-0527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 4483) |
| Enumeration Date | 2009-12-05 |
| Last Update Date | 2009-12-05 |