| NPI | 1063697738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK GREBENER Principal 303-883-4808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW434) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO LAC127) |
| 1041C0700X Social Worker, Clinical (Licence: IL 149010487) | |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2007-12-31 |