| NPI | 1346959582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MOSHER-RAMIREZ Executive D Irector 719-445-0621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QR0800X Clinic/Center, Recovery Care |
| Enumeration Date | 2022-11-16 |
| Last Update Date | 2024-04-12 |