| NPI | 1235454372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY MACDONALD Psychologist 303-573-0839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CO 3052) |
| Additional Taxonomies | 251E00000X Home Health (Licence: CO 3052) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2010-04-01 |