| NPI | 1235350034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIPP DANA CEO 307-885-9883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QA0401X Family Medicine Addiction Medicine | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2022-06-08 |