| NPI | 1548026677 |
|---|---|
| Other Name | BRAD'S HOUSE |
| Entity Type | Organization |
| Authorized Contact | SAMANTHA THOMPSON Hr/Billing 719-639-3776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-02-26 |
| Last Update Date | 2024-02-26 |