| NPI | 1962139022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTOFFER LOREN BOWMAN CEO/Lpc 719-344-5378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 103TF0000X Psychologist Family | |
| 103TP2701X Psychologist Group Psychotherapy | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 225700000X Massage Therapist | |
| 225XM0800X Occupational Therapist Mental Health | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| 163WA0400X Registered Nurse Addiction (Substance Use Disorder) | |
| 163WN1003X Registered Nurse Nutrition Support | |
| 171400000X | |
| 171M00000X Case Manager/Care Coordinator | |
| 207QA0401X Family Medicine Addiction Medicine | |
| 225200000X Physical Therapy Assistant | |
| Enumeration Date | 2022-08-08 |
| Last Update Date | 2022-08-08 |