| NPI | 1104275841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI J DE LUCA Owner 720-504-9444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CO 3669) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2016-06-03 |