| NPI | 1154141133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TANNER Executive Director 307-330-6634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2024-10-14 |
| Last Update Date | 2024-10-14 |