| NPI | 1033990064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK VANDERVEER Authorized Official 970-642-4760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2023-10-05 |