| NPI | 1720663305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENORE LEA SJOBERG Owner 719-337-1240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-03-15 |
| Last Update Date | 2021-03-15 |