| NPI | 1104811256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PABLO HERNANDEZ Superintendent 307-789-3464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 281P00000X Chronic Disease Hospital (Licence: WY 52-01138) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2020-08-22 |