| NPI | 1104672658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE KINOHI Sr. Director Medical Billing 307-426-4727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-04-25 |
| Last Update Date | 2024-04-25 |