| NPI | 1376689042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH WILNER Facility Director 719-276-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: CO 1526789) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility (Licence: CO 1526789) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2012-06-29 |