| NPI | 1487377420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO BENAVIDEZ Owner 719-963-1347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2022-09-23 |
| Last Update Date | 2022-09-23 |