| NPI | 1386340875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKY UBELL Credentialing / Billing Specialist 970-615-0076 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 207R00000X Internal Medicine | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-04-25 |