| NPI | 1134733512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERIE TERRANOVA Operations Director 719-540-2152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 225X00000X Occupational Therapist | |
| 103T00000X Psychologist | |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2025-10-07 |