| NPI | 1144373440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUTUMN MARIE SNYDER Administrative Assistant 307-548-6543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2015-10-29 |