| NPI | 1750148995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BARELA Credentialing Consultant 719-717-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) |
| 163WP0000X Registered Nurse, Pain Management | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-03-04 |