| NPI | 1033575683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY KILGORE Owner 720-722-1440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO LSW.0009920619) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-13 |