NPI | 1760922884 |
---|---|
Entity Type | Organization |
Authorized Contact | SANDRA RAE GOODWIN Part Owner/ Co Director 719-589-6438 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 1653-00) |
Enumeration Date | 2017-03-08 |
Last Update Date | 2017-03-08 |