NPI | 1770363004 |
---|---|
Entity Type | Organization |
Authorized Contact | DEAN JOEL GAINEY Provider / Owner / CEO 719-208-4027 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 101YP2500X Counselor, Professional |
1041C0700X Social Worker, Clinical | |
2084P0800X Psychiatry & Neurology, Psychiatry | |
Enumeration Date | 2023-10-04 |
Last Update Date | 2025-09-02 |