| NPI | 1033483276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY GARDNER Counselor 719-660-5281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 1820) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-06 |