| NPI | 1417581711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA M KULBERG Owner 970-309-1160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-25 |