| NPI | 1073835492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY L. MARGHEIM Program Administrator 970-691-7556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2010-02-26 |
| Last Update Date | 2010-02-26 |