| NPI | 1053926980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYSHELL SCHRADER Billing And Coding Manager 303-412-6091 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-08 |