| NPI | 1902273170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID F DEIKE President 970-214-1343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: CO 27981274) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-24 |