| NPI | 1992248843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY BENEDICT PETRELLI Sole Proprietor 303-569-4588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO LPC.0012121) |
| Enumeration Date | 2016-11-27 |
| Last Update Date | 2016-11-27 |