| NPI | 1689409005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE SHAHBAHRAMI Pmhnp 970-579-0003 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2024-09-05 |