| NPI | 1033531256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN CHANG Owner 719-505-9113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 50799) |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2014-01-07 |