| NPI | 1285367334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZAK CONWAY Therapist 970-761-9908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2022-07-06 |