| NPI | 1063001634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRAH DIANE ARCHER Np/Provider 970-759-5669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2021-01-18 |