NPI | 1568160372 |
---|---|
Entity Type | Organization |
Authorized Contact | CODY GARDNER COO 303-502-7117 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Enumeration Date | 2023-02-21 |
Last Update Date | 2023-11-14 |