| NPI | 1588973085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN MARIE KUGLER Member 719-268-0099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CO 3482) |
| Additional Taxonomies | 251S00000X (Licence: SD 328) |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2024-08-21 |