| NPI | 1699127928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON SCHOU Owner 970-222-7478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 287) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO 9923319) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2016-07-11 |