| NPI | 1477552388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN MOYER CEO 970-945-2840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2024-06-24 |