| 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 |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2020-09-03 |