| NPI | 1316815467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN PETCAVAGE Executive Director 970-484-2023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2025-10-29 |
| Last Update Date | 2025-10-31 |