| NPI | 1245275932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD MOORE CEO 719-543-8711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CO 0849) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2013-09-23 |