| NPI | 1992029532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE JEAN HEMBREE Owner 719-650-4139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 20001205651) |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2010-03-25 |