| NPI | 1740916048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH FARRIS Program Director 719-375-4066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2023-06-09 |