| NPI | 1861973570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA RAE SIMPSON Bookkeeper/Hr 719-578-1227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |