| NPI | 1174561088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN B HUMBLE Director 970-625-3416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACC667) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO NCACII013598) |
| 101YP2500X Counselor, Professional (Licence: CO LPC501) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2020-08-22 |