| NPI | 1447519384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY EDWARD HAZEN Clinical Director 719-520-1732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 1683-00) |
| Enumeration Date | 2012-05-13 |
| Last Update Date | 2012-05-13 |