| NPI | 1235896895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TELICIA SLADE Assistant Director 970-243-3304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2021-11-18 |