| NPI | 1144187881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY RUSSELL Owner/Operator 719-602-0648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2026-01-06 |
| Last Update Date | 2026-01-27 |