| NPI | 1649836982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AICHA FOFANA Owner 720-382-6775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2021-12-16 |