| NPI | 1720821259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA THOMPSON Hr/Billing Director 719-639-3776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-06-13 |