| NPI | 1598455206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB WOOD Owner 970-227-7669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-05-08 |