| NPI | 1962630939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN TUCKER HARDY Physician 719-583-4232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 30618) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2009-06-29 |