| NPI | 1043622756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE ELIZABETH BLACK Lcsw 719-201-0887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO CSW.09923269) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |