Organization
EAGLES NEST RETREAT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN GOWINS PHD (EXECUTIVE DIRECTOR)
(719) 593-7754
Entity
Organization
Contact information
Practice address
6295 LEHMAN DR, SUITE 102, COLORADO SPRINGS, CO 80918-1473
(719) 593-7754
Mailing address
6295 LEHMAN DR, SUITE 102, COLORADO SPRINGS, CO 80918-1473
(719) 593-7754
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
3608
CO
Other
Enumeration date
02/20/2009
Last updated
02/20/2009
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