| NPI | 1023676913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISHA DANIELLE BROADRIGHT Licensed Professional Counselor 719-685-6729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2021-10-22 |