| NPI | 1053704726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH C BLACK Owner/Executive Director 307-654-7003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY 742) |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2024-04-01 |