| NPI | 1053604140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA COURI SCHNIEDWIND Member/Agent 719-229-9739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 333-2) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2011-05-23 |