| NPI | 1497024590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN KUIPER Administrative Support Manager 719-473-4460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CO 1421-00) |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2011-12-19 |