| NPI | 1194931857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORENE M. EWING Administrator 970-241-8896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |