| NPI | 1285918870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKIE M. GRGCIH Sole Proprietor 719-315-0951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 3041) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2011-09-30 |