| NPI | 1942593538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY R PEARSON Director 719-275-8714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO 7038) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CO 4723) |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2011-05-16 |