| NPI | 1356627913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA JOYCE Owner 719-598-0982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CO 20091442120) |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2011-10-27 |