| NPI | 1083908024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVRA FREGIN Interim Executive Director 720-388-6491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CO 20368) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2023-11-07 |