| NPI | 1619664299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA VIGIL Owner 719-251-8759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2023-05-18 |