| NPI | 1053850297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS J. SPARKS President 719-583-0710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2022-02-17 |