| NPI | 1124900998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA CONROY D Irector Credentialing 970-624-4443 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2025-07-23 |
| Last Update Date | 2025-07-23 |