| NPI | 1013402387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA K ELLEGARD Executive Director 719-447-8983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2018-06-28 |