| NPI | 1457191769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITA M JOHNSON Clinical Director 303-808-8466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 261QC1500X Clinic/Center Community Health | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-05-27 |
| Last Update Date | 2024-05-27 |