| NPI | 1215456793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH L HICKMAN Executive Director 970-522-4549 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CO 1145-05) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2021-07-15 |