| NPI | 1548947633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ROB6 Addiction Specialist 719-203-7864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2023-06-29 |