| NPI | 1801720404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY JENSON CEO 385-352-9696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 175T00000X Peer Specialist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2026-06-09 |
| Last Update Date | 2026-06-09 |