NPI | 1578758207 |
---|---|
Entity Type | Organization |
Authorized Contact | MITCHELL BRENT LIESTER Chairman/Owner 719-488-0024 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CO 29395) |
Enumeration Date | 2007-09-06 |
Last Update Date | 2007-09-06 |