| NPI | 1336909241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA HARGRAVE Owner 719-351-3586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| 2083A0300X Preventive Medicine, Addiction Medicine | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2024-10-03 |