| NPI | 1578370060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY GERALD STEHLIK CEO 719-645-0136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2024-12-17 |
| Last Update Date | 2025-03-19 |