| NPI | 1063783520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH R GAMBLIN President 719-578-1119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 17345) |
| Enumeration Date | 2012-01-14 |
| Last Update Date | 2012-02-11 |