| NPI | 1164936274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA FRASER Program Director 970-978-4386 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone (Licence: CO 1648-03) |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2017-11-28 |