| NPI | 1568992683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN M. WILSON Executive Director 970-380-7885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2025-09-12 |