| NPI | 1083739106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNA LOCKWOOD Regional Director 307-782-6601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |