| NPI | 1780116855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN ISADORE MALKIN Owner 720-441-4564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0012187) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-04-13 |