| NPI | 1497337109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES D YOUNG Owner 720-569-1079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2023-03-07 |