| NPI | 1871396861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM WALLS Owner 719-301-5458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2025-03-27 |
| Last Update Date | 2025-11-25 |