| NPI | 1588289730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIVIA DANIELA DUMESNIL Program Director 970-978-1768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-06-13 |
| Last Update Date | 2020-06-13 |