| NPI | 1073953287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCY WILLIAMSON Executive Director 307-632-3640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2013-07-02 |