| NPI | 1962122291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY BRANNEN Owner 970-342-5440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2022-09-13 |