| NPI | 1750100129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | URSULA LYNETTE HOLLINS Executive Director 719-696-9027 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2024-10-03 |
| Last Update Date | 2024-10-03 |