| NPI | 1164120796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHEYENNE ELAINE SHIPMAN Owner 719-413-5261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-02-22 |
| Last Update Date | 2025-07-18 |