| NPI | 1003764937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY WEILAND Onwer 719-319-8437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2026-03-17 |
| Last Update Date | 2026-03-17 |