| NPI | 1134962616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBI BARRETT Controller 307-332-2231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-06-13 |