NPI | 1053914788 |
---|---|
Entity Type | Organization |
Authorized Contact | KIMBERLEE BALAGAT Owner 719-696-8426 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2020-11-17 |
Last Update Date | 2023-04-20 |