| NPI | 1740943836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA CARTER Licensed Clinical Social Worker 719-924-5331 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-10-16 |
| Last Update Date | 2021-10-16 |