| NPI | 1780395798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUSTIN THOMAS KOPAS Chief Nurse Practitioner 719-629-7723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2024-03-29 |