| NPI | 1891598892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM WALLS Owner 719-301-5458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-03-27 |
| Last Update Date | 2025-03-27 |