| NPI | 1164755468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMEA RAE SISCO Cad 303-782-0599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CO ACD-136) |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2009-09-17 |