| NPI | 1356620017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANTINO CRUZ Director 303-642-5502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: CO 20111421085) |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2011-08-12 |