| NPI | 1689002966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMINA BLASKO Owner 719-650-3921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO LPCC.0013421) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2013-10-23 |