| NPI | 1205102985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN E. NIEBLING Clinical Manager 303-370-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 94) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |