| NPI | 1104333400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN GRAY Owner 720-773-1264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 4488) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 871) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2018-01-08 |