| NPI | 1063172336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA STAINBROOK Managing Partner 970-978-8105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2021-12-28 |
| Last Update Date | 2021-12-28 |