| NPI | 1023591104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCELLO LA ROCCA Executive Director 720-372-1490 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2019-10-28 |