| NPI | 1689447716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN DAVID MATTICE CEO 719-789-5307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2023-10-31 |
| Last Update Date | 2025-07-29 |