| NPI | 1386419323 |
|---|---|
| Doing Business As | SOUTHERN COLORADO INTERVENTIONAL PSYCHIATRY |
| Entity Type | Organization |
| Authorized Contact | JONATHAN GRAVGAARD Owner Operator 678-468-3068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2023-11-20 |