| NPI | 1265049639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY REUILLE-DUPONT Manager 970-749-8227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2020-09-29 |