| NPI | 1306178017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BRUCE WENZEL Clinical Director 719-593-9228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 3204) |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2010-02-04 |