| NPI | 1336777895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CIARA JEAN MCCOY Mental Health Therapist 970-368-2428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2020-03-31 |