| NPI | 1649629114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN WALLACH Mental Health Counselor 720-822-6795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 0181511) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2016-06-06 |