| NPI | 1215299904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE SNYDER Owner/CEO 307-761-1993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY 903) |
| 1041C0700X Social Worker, Clinical (Licence: WY 447) | |
| Enumeration Date | 2012-06-09 |
| Last Update Date | 2014-06-11 |