| NPI | 1245867449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT SHANNON Owner 970-221-1106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2025-08-26 |