| NPI | 1629796669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENILLE GUDAHL Owner 970-361-1038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2023-05-18 |