| NPI | 1265022677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHYANNE CHING CFO 719-569-5517 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2023-11-05 |