| NPI | 1891118949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKI LASHAWN HARRELL Provider 720-885-0827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2014-01-26 |
| Last Update Date | 2014-01-26 |