| NPI | 1114698636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN ANDREW SMITH Owner 970-518-5266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2023-04-05 |