| NPI | 1336838127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN VYZOUREK President 719-291-3406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2023-05-05 |