| NPI | 1871481150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTTQ LISTER COO 970-987-2583 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-06-25 |