| NPI | 1104091941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA T JOHNSTON President 303-691-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CO 4764) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2012-09-10 |