| NPI | 1184163602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH BOWMAN Director 719-585-4042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2024-02-22 |