| NPI | 1235973660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK HAGGARD Billing Manager 719-204-4548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2024-06-20 |
| Last Update Date | 2024-06-20 |