| NPI | 1093792095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY R CONGER Executive Director 307-789-7915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WY 106662500) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2022-08-08 |