| NPI | 1801181169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL BECKER CEO 970-668-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2024-06-13 |