| NPI | 1447025762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL PATTERSON Health Services Administrator 719-429-7198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health |
| Enumeration Date | 2023-11-16 |
| Last Update Date | 2023-11-16 |