| NPI | 1336909241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA HARGRAVE Owner 719-351-3586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2024-03-19 |