| NPI | 1962821934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYCE MATHERN Owner 303-835-6886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO NLC.0104032) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2014-04-07 |