| NPI | 1508381203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN DENISE PURYEAR Executive Director 719-238-7908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2018-10-30 |