| NPI | 1528549375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLTON MCNUTT Owner 719-761-7230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CO 3886) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CO 3886) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CO 3886) | |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2018-08-28 |