| NPI | 1184854689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER B JONES-ROBINSON Owner 307-673-4647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY LPC - 790) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: WY LPC 790) |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: WY LPC - 790) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: WY LAT - 294) | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children (Licence: WY LPC-790) | |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2013-02-20 |