| NPI | 1235895244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN GRAVES Management Agent 970-823-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-11-14 |
| Last Update Date | 2021-11-24 |