| NPI | 1861753931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN HARSH CEO/Cmo 719-384-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 115077) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO 991295) |
| 101YM0800X Counselor, Mental Health | |
| 261Q00000X Clinic/Center | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2020-01-09 |