| NPI | 1558909366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTELLE ROCKMAN Executive Director 719-313-0626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2022-02-24 |