| NPI | 1336463488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA FITZGERALD Owner 719-589-2974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: CO AA86) |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2010-03-18 |