| NPI | 1477553014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY SITES Practice Manager 303-315-5213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CO 57477) |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: CO 57477) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2020-08-22 |