| NPI | 1013509959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOU CHARARA Administrator 303-885-4774 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2021-02-10 |