| NPI | 1487536256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANA CONROY Director Of Credentialing 970-624-4443 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2025-07-23 |
| Last Update Date | 2025-07-23 |