| NPI | 1184748584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LYNN MELLOTT Member Administrator 307-334-0177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: WY 07005) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |