| NPI | 1790551331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISHA LYNNE BASHAW Owner 970-227-7989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2023-12-18 |