| NPI | 1962257329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADA HENDRICKSON Therapist 719-728-9239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-04-19 |
| Last Update Date | 2024-04-19 |