| NPI | 1184216780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CARMAN Executive Assistant 970-221-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2021-02-05 |