| NPI | 1518239219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATA RAMACHANDRAN Executive Director 970-200-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CO 18U295) |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2025-02-18 |