| NPI | 1053074351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA THOMPSON Hr/Billing Director 719-639-3776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2021-10-14 |
| Last Update Date | 2023-09-20 |