| NPI | 1861232803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON J BURNS Executive Director 719-648-1997 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-05-28 |
| Last Update Date | 2024-06-13 |