| NPI | 1386038545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JANKELOW Owner/Np 719-766-8511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2025-06-09 |