| NPI | 1164989745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE HANEY Managing Member 719-468-0547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 261QR1300X Clinic/Center Rural Health |
| 251S00000X Community/Behavioral Health | |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QR1100X Clinic/Center Research | |
| 3104A0625X Assisted Living Facility Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2021-07-19 |