| NPI | 1255792883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY VILLENEUVE Business Directorr 307-287-1184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2017-02-08 |