| NPI | 1265350433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYATT OVERTON Owner 970-301-8755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-07-07 |
| Last Update Date | 2026-07-23 |