| NPI | 1134953490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KACEY JONES Administrative COO Rdinator/Rcm Lead 307-347-6165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| 261QR0800X Clinic/Center Recovery Care | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2024-08-29 |
| Last Update Date | 2025-07-21 |