| NPI | 1144707878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE THOEBALD Owner 720-724-3668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CO 52028) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2020-12-08 |