| NPI | 1043937576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY WOLFF CFO 970-346-2546 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2022-10-25 |
| Last Update Date | 2023-05-29 |