| NPI | 1093252298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONALISA RANDOLPH Owner Administrator 719-250-3048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 372600000X Adult Companion (Licence: CO 23Q662) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |