| NPI | 1053837153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERLA RAMIREZ-GROOTHUIS Executive Director 970-978-4386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: CO 1648-03) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2022-07-21 |