| NPI | 1215561857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER PHIPPEN Owner 970-239-3553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-02-22 |
| Last Update Date | 2021-09-13 |