| NPI | 1407398621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER JON ERIKSON THOMAS Executive Director 719-237-4641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2016-11-07 |