| NPI | 1740538909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYANA ADDISON OWENS Owner 720-499-9617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CO CSW-1608) |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2012-08-20 |