| NPI | 1205087962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEYLA DIM Director 307-587-6288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WY PPC-392) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |