| NPI | 1023606746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELLE MARIE DUHON Executive Director 307-231-6704 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2021-01-07 |