| NPI | 1912732090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK HAGGARD Billing Manager 719-308-1213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2024-09-06 |
| Last Update Date | 2025-04-15 |