| NPI | 1851714349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MARIE REILLY Owner 970-623-6369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TN 1-11-9563) |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2014-02-04 |