| NPI | 1780039784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MCFADDEN Director 719-275-7650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO NLC0106295) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |