| NPI | 1821737958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACEY RICHARDS Human Resources 719-466-4809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2022-05-27 |