| NPI | 1902443922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY SIMMONS Owner/Therapist 970-400-7024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2019-12-09 |