| NPI | 1154169662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHELLE AURA POWER Owner 719-287-4782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology Addiction Psychiatry |
| Enumeration Date | 2024-07-18 |
| Last Update Date | 2024-07-18 |