| NPI | 1598415929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK MENSAH Director 970-310-3034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2022-03-28 |