| NPI | 1114433612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH D LANIER Officer 303-524-5972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2018-03-17 |