| NPI | 1316429756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERONILDE CHAVES BUCKLEY Licensed Professional Counselor 719-359-3431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0014711) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0000874) |
| Enumeration Date | 2018-09-01 |
| Last Update Date | 2018-10-31 |