| NPI | 1912713231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA SUNDEEN Owner 719-247-3152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2024-12-10 |
| Last Update Date | 2024-12-13 |