| NPI | 1295858892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY I VILLALOVOS Clinician 719-359-5431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 63467) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |