| NPI | 1982259594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GASPER JACQUES Owner 303-513-3391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2019-08-09 |