| NPI | 1609390053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT BRUNO Owner 719-453-5780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CO lpc0005002) |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2022-04-06 |