| NPI | 1477366490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY MALLETT CEO 719-357-5546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2025-01-31 |
| Last Update Date | 2025-02-03 |