| NPI | 1194124404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE OLDS Credentialing/Insurance Specialist 303-793-9634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 0011556) |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2014-08-22 |