| NPI | 1598031692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN D BIRNKRANT Medical Director 970-300-1845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CO 45539) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CO 4679) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 45539) | |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-03-22 |