| NPI | 1609713338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIGHANNA NORDSTROM Owner 970-233-9740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-04-30 |
| Last Update Date | 2026-04-30 |