| NPI | 1215007083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA J ACKER Executive Director 307-352-6680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2013-09-09 |