NPI | 1508618455 |
---|---|
Entity Type | Organization |
Authorized Contact | FANNIE SHARIEE JOHNSON Owner 720-829-4471 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
324500000X Substance Abuse Rehabilitation Facility | |
Enumeration Date | 2024-04-03 |
Last Update Date | 2025-07-10 |