| NPI | 1548932551 |
|---|---|
| Other Name | RESPITE SUITE 104 |
| Entity Type | Organization |
| Authorized Contact | JENNIFER RUDNIK Credentialing Manager 719-423-1341 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 385H00000X Respite Care |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2022-06-09 |