| NPI | 1174679195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNE L. HINES Acct Supervisor 307-674-6878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: WY 6190) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2013-05-23 |