| NPI | 1902350788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF RICHARD KISICKI Executive Director 303-433-0188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 992298) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2016-08-09 |