| NPI | 1104735711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTINA F FONSECA CEO 307-256-6690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2026-09-02 |
| Last Update Date | 2026-09-02 |