| NPI | 1912460056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL COVELLI Operating Officer 719-651-7584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-04-06 |
| Last Update Date | 2022-03-14 |