| NPI | 1093090656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BUCKINGHAM VP Of It 307-684-5531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2023-08-11 |