| NPI | 1245626787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON POLK Therapist 720-272-9573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO CSW.09923905) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: CO ACD.0000426) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2015-04-10 |