| NPI | 1275172967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN S MORGENTHALER Executive Director 719-564-5070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-12-30 |
| Last Update Date | 2019-12-30 |