| NPI | 1255987657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRIA A BROCKMAN Owner/Provider 307-287-5377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2019-08-13 |