| NPI | 1043459118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BUCKINGHAM VP Of It And Compliance 307-672-0475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2021-07-01 |