| NPI | 1477959617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY J GARCIA Director 719-588-6777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 2839) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 1851) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |