| NPI | 1164775250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT RICHARD MAES Clinical Director 719-240-1799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 1727-01) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2021-04-15 |