| NPI | 1720482722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORRISA J VANDYKE Psychotherapist 719-464-4710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 0006093) |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2016-02-07 |