| NPI | 1003498270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLON MARTELL SANGO Director 720-668-6482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2024-06-10 |