| NPI | 1700889151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE SOBCZAK Executive Director 719-336-0261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: CO 0610) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2024-05-15 |