| NPI | 1831643444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA JEAN ISACCO Tasc Program Coordinator 720-771-5552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2016-08-11 |