| NPI | 1992027999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL VAN DINTER Registered Agent 719-634-8229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO 921) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |