| NPI | 1508100488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA KENNEL Sole Proprietor 303-730-1144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 5737) |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2012-11-16 |