| NPI | 1124852355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KACEY JONES Rcm Lead 307-347-6165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-08-29 |
| Last Update Date | 2024-08-29 |