| NPI | 1841326840 |
|---|---|
| Doing Business As | WILLOW HOUSE |
| Entity Type | Organization |
| Authorized Contact | KINDRA D LAMBERT General Manager 719-589-5734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |