NPI | 1184431355 |
---|---|
Entity Type | Organization |
Authorized Contact | AUGUST BRUCE WAGNER Therapist 970-567-5203 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2024-12-11 |
Last Update Date | 2024-12-11 |