| NPI | 1215158407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN ANNE VACCARELLA Owner 303-994-0673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 4255) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: CO 4255) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2012-03-16 |