| NPI | 1144706268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA LYNN AXTON Managing Member 719-284-0319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO LPCC.0015936) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2019-06-11 |