| NPI | 1730699984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY SWANSON Owner 719-641-4917 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO acb7020) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO cswoo923464) |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2018-03-17 |