| NPI | 1407395171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL LYNN MOWRY Owner 720-273-7598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 20171121266) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-14 |