| NPI | 1104062314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE WILLETTE COO, CFO 307-234-8710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 163WC0400X Registered Nurse, Case Management | |
| 101Y00000X Counselor | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2008-12-18 |
| Last Update Date | 2008-12-18 |