| NPI | 1114180486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENAY MARIE CRAIN Director 719-438-5782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: CO 121733) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2010-11-09 |