| NPI | 1003301904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE HAUSER Executive Director 307-745-8997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101Y00000X Counselor | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| 1041C0700X Social Worker Clinical | |
| 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2025-09-04 |