| NPI | 1205051232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY NARVET CFO 719-344-6188 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 18812) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2018-09-12 |