| NPI | 1619300720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK PUTNOY Clinical Supervisor 303-257-6715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CO 1667-01) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CO 1667-01) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2013-08-12 |