| NPI | 1497198089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA DICKEY Pa 719-661-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CO PA3627) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2013-04-13 |