| NPI | 1760285761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM WALLS Owner 719-362-0558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 101YP2500X Counselor, Professional | |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| Enumeration Date | 2025-03-27 |
| Last Update Date | 2025-11-25 |