| NPI | 1154650455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS BERGER Manager 970-227-2770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 9852) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO 9852) |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2015-06-18 |