| NPI | 1548566060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY BROOKS Supervisor 303-714-1084 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CO 73952) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2011-01-31 |