NPI | 1205195807 |
---|---|
Entity Type | Organization |
Authorized Contact | VICTORIA C YOUNGBLOOD Owner/Director 719-459-6710 |
Organization Subpart ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 1575) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 4082) |
Enumeration Date | 2012-05-16 |
Last Update Date | 2012-05-16 |