| NPI | 1619370343 |
|---|---|
| Doing Business As | GENESIS OUTPATIENT |
| Entity Type | Organization |
| Authorized Contact | BARBARA M VONDERHARR Owner/Manager 719-632-3510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CO 1728-01) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2024-10-31 |