| NPI | 1366329740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONI DAVIS Licensed Clinical Social Worker 719-330-0005 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-08-19 |
| Last Update Date | 2025-08-19 |