| NPI | 1104954569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE M WASHINGTON Credentialing Director 303-912-7193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251T00000X PACE Provider Organization |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2019-04-04 |