| NPI | 1881235539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE L WILSON Owner 719-661-8061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2022-04-08 |