| NPI | 1679092654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY LEE MOWERY President/Owner 719-433-1407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CO 00) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO 00) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2022-07-21 |