| NPI | 1144465642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMAS FREDERICK KELLY Owner/Director 970-484-5625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CO 30397) |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2012-06-05 |