| NPI | 1417775842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE BOWEN CEO 719-209-2132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-10-03 |
| Last Update Date | 2024-10-03 |