| NPI | 1952177479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHESTER DEANGELIS Clinical Services Director 719-495-3908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2023-11-27 |