| NPI | 1215171947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANEL BORT President 970-214-7045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WY LPC-986) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY LPC-986) |
| 101YM0800X Counselor, Mental Health (Licence: WY LPC-986) | |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2012-05-11 |