| NPI | 1306170964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENE' J HENDERSON Owner/Therapist 719-380-1644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: CO 2345) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health (Licence: CO 2345) |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: CO 2345) | |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2017-02-17 |