| NPI | 1750074464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIGAIL E MALLEY Clinical Social Worker 970-988-3576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2023-09-30 |