| NPI | 1407681174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL K CHISM Owner 720-507-4779 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-09-03 |
| Last Update Date | 2024-09-03 |