| NPI | 1477064590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PALMER W JOHNSON Director 719-635-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO 991344) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2021-04-28 |