| NPI | 1174131130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY POTTORFF Executive Director 970-347-2373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2020-07-16 |