| NPI | 1669142162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENOCH AMOAH Administrator 720-499-8685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2021-09-15 |