| NPI | 1538673553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM R MUSGRAVE Owner 970-682-4353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CO 20171759951) |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2017-11-29 |