| NPI | 1730217787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN P. ANDERSON Facility Administrator 970-224-0495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 1579-01) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |