| NPI | 1902239221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY PERRY Chief Executive Officer/President 719-545-2746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2013-08-11 |
| Last Update Date | 2015-12-12 |