| NPI | 1245536168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI GORMAN Sole Proprietor 719-784-7522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 993001) |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2011-02-10 |